| Fetal surgery for congenital diaphragmatic hernia: the North American experience. | |
| | |
MedLine Citation:
|
PMID: 16050528 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The role for fetal surgery in treating fetuses with congenital diaphragmatic hernia (CDH) is unclear. Two decades of investigation have improved our understanding of the prenatal natural history, pathophysiology, and outcomes of these patients. During this same period, there have been advances in fetal surgery techniques including improvements in fetal monitoring, maternal-fetal anesthesia, tocolysis, and improved instrumentation to permit increased application of videoscopic approaches. Because of technical challenges, open fetal repair of CDH has been abandoned. Fetal tracheal ligation has shown promise, but a recently published prospective, randomized trial failed to show a benefit of fetoscopic tracheal ligation compared with expert postnatal treatment. Although there is evidence that postnatal outcomes for infants with this disease have improved with the adoption of gentilation ventilator management, high-frequency ventilation, and ECMO, there continues to be a subset of infants with severe CDH that die or suffer serious long-term morbidity despite advanced surgical care. The purpose of this article is to review issues related to prenatal diagnosis, patient selection, and outcomes for fetal surgery; and ultimately to assess whether there is a role for fetal surgery in treating fetuses with CDH. |
| | |
Authors:
|
Darrell L Cass |
Related Documents
:
|
19020528 - Relationship between oxygen saturation and the mode of oxygen delivery used in newborn ... 20509108 - Impact of target blood gases on outcome in congenital diaphragmatic hernia (cdh). 11230598 - International experience with trisomy 21 infants placed on extracorporeal membrane oxyg... 7072998 - Neonatal neurobehavioral effects of inhalation analgesia for vaginal delivery. 7645618 - Cohort study of twinning in an academic health center: changes in management and outcom... 16647918 - Plurality-dependent risk of severe intraventricular hemorrhage among very low birth wei... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Seminars in perinatology Volume: 29 ISSN: 0146-0005 ISO Abbreviation: Semin. Perinatol. Publication Date: 2005 Apr |
Date Detail:
|
Created Date: 2005-07-29 Completed Date: 2005-10-20 Revised Date: 2005-11-16 |
Medline Journal Info:
|
Nlm Unique ID: 7801132 Medline TA: Semin Perinatol Country: United States |
Other Details:
|
Languages: eng Pagination: 104-11 Citation Subset: IM |
Affiliation:
|
Texas Center for Fetal Surgery, Texas Children's Hospital Clinical Care Center, Houston, TX 77030, USA. dcass@bcm.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Balloon Occlusion Female Fetoscopy Hernia, Diaphragmatic / congenital, diagnosis*, surgery* Humans Pregnancy Prenatal Diagnosis* Treatment Outcome United States |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Fetal intervention for congenital diaphragmatic hernia: the European experience.
Next Document: Evidence-based management of infants with congenital diaphragmatic hernia.