Document Detail


Congenital diaphragmatic hernia: advances in prenatal therapy.
MedLine Citation:
PMID:  14533889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite intensive clinical and experimental efforts, mortality from CDH remains high. More than two decades of research in multiple centers has led to a better understanding of the pathophysiology, prognosis, and treatment options for fetuses that have CDH. It now appears that fetuses that have prenatally diagnosed CDH can be stratified into high- and low-risk groups based upon sonographic parameters. Fetuses that do not have liver herniation into the chest that have a favorable LHR have an excellent chance of survival with postnatal therapy. Prenatal diagnosis allows the time and place of delivery to be planned in advance so these infants can be treated in a tertiary care nursery that has maximal medical and surgical therapy. Fetuses that have liver herniation into the chest and an unfavorable LHR have a grim prognosis. These fetuses might benefit from in utero intervention. There is no role for open fetal repair of the diaphragmatic detect; however, fetoscopic temporary tracheal occlusion might improve lung growth and development and might decrease morbidity and mortality in these infants. The FETENDO strategy appears to work, and for the first time it offers hope to the fetus that has high-risk CDH, but its efficacy must be proven in a proper randomized, controlled trial.
Authors:
Roman M Sydorak; Michael R Harrison
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinics in perinatology     Volume:  30     ISSN:  0095-5108     ISO Abbreviation:  Clin Perinatol     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-10-09     Completed Date:  2003-11-06     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7501306     Medline TA:  Clin Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-79     Citation Subset:  IM    
Affiliation:
Department of Surgery, Fetal Treatment Center, University of California-San Francisco, 513 Parnassus Avenue, HSW-1601, San Francisco, CA 94143-0570, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cesarean Section / methods
Female
Fetal Diseases / diagnosis,  surgery*
Fetoscopy
Hernia, Diaphragmatic / congenital,  diagnosis,  surgery*
Humans
Infant, Newborn
Postnatal Care
Pregnancy
Prenatal Diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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