Link: https://www.ncbi.nlm.nih.gov/pubmed/30772144

Best Pract Res Clin Obstet Gynaecol. 2019 Jan 5. pii: S1521-6934(130263-3. doi: 10.1016/j.bpobgyn.2018.12.010. [Epub ahead of print]
Prenatal diagnosis and management of congenital diaphragmatic hernia.
Basurto D1, Russo FM2, Van der Veeken L2, Van der Merwe J2, Hooper S3, Benachi A4, De Bie F1, Gomez O5, Deprest J6.
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Abstract
Congenital diaphragmatic hernia is characterized by failed closure of the diaphragm, thereby allowing abdominal viscera to herniate into the thoracic cavity and subsequently interfering with normal lung development. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension (PHT), that is lethal in up to 32% of patients. In isolated cases, the outcome may be predicted prenatally by medical imaging and advanced genetic testing. In those fetuses with a predicted poor outcome, fetoscopic endoluminal tracheal occlusion may be offered. This procedure is currently being evaluated in a global randomized clinical trial (www.TOTALtrial.eu). We are currently investigating alternative strategies including transplacental sildenafil administration to reduce the occurrence of persistent PHT.

Copyright © 2018. Published by Elsevier Ltd.

KEYWORDS:
Congenital diaphragmatic hernia; Prenatal prediction; Prenatal therapy; Pulmonary hypoplasia; Sildenafil

PMID: 30772144 DOI: 10.1016/j.bpobgyn.2018.12.010