Current and future antenatal management of isolated congenital diaphragmatic hernia
- PMID: 29169875
- DOI: 10.1016/j.siny.2017.11.002
Current and future antenatal management of isolated congenital diaphragmatic hernia
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.
Copyright © 2017 Elsevier Ltd. All rights reserved.
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