Severe Congenital Diaphragmatic Hernia—Exemplary Management in Poland: Fetoscopic Endotracheal Occlusion

Abstract

ABSTRACT Congenital diaphragmatic hernia (CDH) is a developmental closure defect resulting in discontinuity of the diaphragm. Abdominal viscera herniate into the chest leading to mediastinal shift and lung compression. Congenital diaphragmatic hernia occurs in approximately 1 in 4,000 live births. Vast majority of cases is on the left side of the diaphragm. Congenital diaphragmatic hernia is also associated with severe pulmonary hypoplasia and pulmonary arterial hypertension. Approximately 50 to 70% of cases of CDH are isolated, but may also be associated with rare and severe genetic syndromes. It is one of the most severe birth defects with extremely high neonatal mortality and morbidity. Prognosis is worse in cases of an abnormal chromosomal microarray, severe associated anomalies, right-sided defect, liver herniation, and lower fetal lung volume. In some countries, fetoscopic endotracheal occlusion (FETO) for severe CDH is offered to selected group of patients. Since 2014, this procedure is also available in Poland in the 1st Department of Obstetrics and Gynecology of Medical University of Warsaw. This article reviews management in diaphragmatic hernia and presents protocol implemented in our center. How to cite this article Wielgos M, Kosinski P. Severe Congenital Diaphragmatic Hernia—Exemplary Management in Poland: Fetoscopic Endotracheal Occlusion. Donald School J Ultrasound Obstet Gynecol 2016;10(2):178-179.