Most fetuses diagnosed before 24 weeks gestation with a congenital diaphragmatic hernia (CDH) die despite optimal postnatal care. Complete in utero repair of CDH has been very unsuccessful. New strategies for temporary tracheal occlusions prenatally have since been developed to gradually enlarge the hypoplastic lung. Obstructing the normal passage of fetal lung fluid enlarges developing fetal lungs,ac celerates lung growth,and reduces the herniated vis cera,resulting in improved pulmonary function after birth. With ongoing experimental and clinical research,different techniques for tracheal occlusions have evolved.
Goldstein RB : Ultrasound evaluation of the fetal thorax,in Callen PW (ed):Ultrasonography in Obstetrics and Gynecology. 4th ed.Philadelphia,WB Saunders Company,2000,pp 433–438.
2.
Innovations—Congenital Diaphragmatic Hernia. Available at http://www.fetus.ucsf.edu/ftc/innovations/innov2_r.html Accessed February 20, 2001.
3.
Harrison MR,Adzick NS ,Flare AW,et al: Correction of congenital diaphragmatic hernias in utero: VIII: response of the hypoplastic lung to tracheal occlusion. J Pediatr Surg1996;31:1339–1348.
4.
Hernia, Diaphragmatic. Available at http://drhull.com/EncyMaster/H/diaphragmatic_hernia.html Accessed February 20, 2001.
5.
Harrison MR ,Mychaliska GB,Alanese CT,et al: Correction of congenital diaphragmatic hernia in utero: IX: fetuses with poor prognosis (liver herniation and low lung-to-head ratio) can be saved by fetoscopic tracheal occlusion. J Pediatr Surg1998;33:1017–1037.
6.
Vanderwalk KJ ,Skarsgard ED,Filly RA,Eckert J,Harrison MR: Fetendo-clip: a fetal endoscopic tracheal clip procedure in a human fetus. J Pediatr Surg1997;32:970–972.
