Current and future antenatal management of isolated congenital diaphragmatic hernia

Francesca Maria Russo; Paolo De Coppi; Karel Allegaert; Jaan Toelen; Lennart van der Veeken; George Attilakos; Mary Patrice Eastwood; Anna Louise David; Jan Deprest

doi:10.1016/j.siny.2017.11.002

Current and future antenatal management of isolated congenital diaphragmatic hernia

Semin Fetal Neonatal Med. 2017 Dec;22(6):383-390. doi: 10.1016/j.siny.2017.11.002. Epub 2017 Nov 21.

Authors

Francesca Maria Russo¹, Paolo De Coppi², Karel Allegaert³, Jaan Toelen¹, Lennart van der Veeken¹, George Attilakos⁴, Mary Patrice Eastwood⁵, Anna Louise David⁴, Jan Deprest⁶

Affiliations

¹ Academic Department of Development and Regeneration, Clinical Specialties Research Groups, Biomedical Sciences; Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium.
² Academic Department of Development and Regeneration, Clinical Specialties Research Groups, Biomedical Sciences; Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium; Institute for Women's Health and Institute of Child Health, University College London, London, UK; Great Ormond Street Hospital, London, UK.
³ Academic Department of Development and Regeneration, Clinical Specialties Research Groups, Biomedical Sciences; Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium; Erasmus Medical Centre, Sophia Hospital for Children, Intensive Care Unit for Children, Rotterdam, The Netherlands.
⁴ Institute for Women's Health and Institute of Child Health, University College London, London, UK.
⁵ Academic Department of Development and Regeneration, Clinical Specialties Research Groups, Biomedical Sciences; Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium; Institute for Women's Health and Institute of Child Health, University College London, London, UK.
⁶ Academic Department of Development and Regeneration, Clinical Specialties Research Groups, Biomedical Sciences; Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium; Institute for Women's Health and Institute of Child Health, University College London, London, UK. Electronic address: jan.deprest@uzleuven.be.

PMID: 29169875
DOI: 10.1016/j.siny.2017.11.002

Abstract

Congenital diaphragmatic hernia is surgically correctable, yet the poor lung development determines mortality and morbidity. In isolated cases the outcome may be predicted prenatally by medical imaging. Cases with a poor prognosis could be treated before birth. However, prenatal modulation of lung development remains experimental. Fetoscopic endoluminal tracheal occlusion triggers lung growth and is currently being evaluated in a global clinical trial. Prenatal transplacental sildenafil administration may in due course be a therapeutic approach, reducing the occurrence of persistent pulmonary hypertension, either alone or in combination with fetal surgery.

Keywords: Congenital diaphragmatic hernia; Prenatal therapy; Pulmonary hypertension; Pulmonary hypoplasia; Sildenafil.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Female
Fetoscopy / trends*
Hernias, Diaphragmatic, Congenital / diagnostic imaging
Hernias, Diaphragmatic, Congenital / surgery*
Humans
Pregnancy
Prognosis
Ultrasonography, Prenatal*

Abstract

Publication types

MeSH terms

Grants and funding