Document Detail


Prenatal management of the fetus with isolated congenital diaphragmatic hernia in the era of the TOTAL trial.
MedLine Citation:
PMID:  25447987     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Congenital diaphragmatic hernia (CDH) may be isolated or associated with other structural anomalies, the latter with poor prognosis. The defect allows viscera to herniate through the defect into the chest, competing for space with the developing lungs. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension that is lethal in up to 30% of patients. When isolated, survival chances can be predicted by antenatal measurement of lung size and liver herniation. Chromosomal microarrays and exome sequencing contribute to understanding genetic factors underlying isolated CDH. Prenatal intervention aims at stimulating lung development, clinically achieved by percutaneous fetal endoscopic tracheal occlusion (FETO) under local anesthesia. The Tracheal Occlusion To Accelerate Lung growth trial (www.totaltrial.eu) is an international randomized trial investigating the role of fetal therapy for severe and moderate pulmonary hypoplasia. Despite an apparent increase in survival following FETO, the search for lesser invasive and more potent prenatal interventions must continue.
Authors:
Jan Deprest; Paul Brady; Kypros Nicolaides; Alexandra Benachi; Christoph Berg; Joris Vermeesch; Glenn Gardener; Eduard Gratacos
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Publication Detail:
Type:  REVIEW     Date:  2014-11-11
Journal Detail:
Title:  Seminars in fetal & neonatal medicine     Volume:  -     ISSN:  1878-0946     ISO Abbreviation:  Semin Fetal Neonatal Med     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  101240003     Medline TA:  Semin Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Ltd. All rights reserved.
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