Changing perspectives on the perinatal management of isolated congenital diaphragmatic hernia in Europe

• Autores: Jan Deprest, Eduardo Gratacós Solsona, Kypros H. Nicolaides, Elise Done, Tim van M¡eghem, Leonardo Gucciardo, Filip Claus, Anne Debeer, Karel Allegaert, Irwin Reiss, Dick Tibboel
• Localización: Clinics in Perinatology, ISSN 0095-5108, Vol. 36, Nº. 2, 2009 (Ejemplar dedicado a: Fetal surgery / coord. por Hanmin Lee), págs. 329-347
• Idioma: inglés
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• Resumen

  • Congenital diaphragmatic hernia (CDH) should be diagnosed in the prenatal period and prompt referral to a tertiary referral center for imaging, genetic testing, and multidisciplinary counseling. Individual prediction of prognosis is based on the absence of additional anomalies, lung size, and liver herniation. In severe cases, a prenatal endotracheal balloon procedure is currently being offered at specialized centers. Fetal intervention is now also offered to milder cases within a trial, hypothesizing that this may reduce the occurrence of bronchopulmonary dysplasia in survivors. Postnatal management has been standardized by European high-volume centers for the purpose of this and other trials.