The diaphragm is a thin muscle between the chest and abdomen that aids breathing. In some unborn babies, the diaphragm does not form properly and a hole develops. This opening allows organs, such as the intestines, to move upwards into the chest where they interfere with lung growth.
This condition is known as congenital diaphragmatic hernia (CDH).
Congenital Diaphragmatic Hernia Treatment: Why Choose Us?
Specialists at the Fetal Care Center are experts in CDH diagnosis and treatment. Our pediatric surgical specialists at St. Louis Children’s Hospital are leaders in both clinical care and research to treat CDH and improve the well-being of children born with this birth defect.
Barrett, prenatally diagnosed with a congenital diaphragmatic hernia (CDH). Pregnancy care, delivery and postnatal surgery were all coordinated through the Fetal Care Center. Barrett is now receiving follow-up care with the St. Louis Children’s Hospital CDH Clinic.
About Congenital Diaphragmatic Hernia
CDH is a rare birth defect, affecting approximately 1 out of every 2,500 newborns. Some babies with CDH have long-term health problems, such as breathing problems, feeding issues and developmental, physical and speech delays.
When abdominal organs enter the chest cavity through the diaphragmatic hernia, they may affect the heart and lungs. Some babies with CDH experience:
- Heart problems: The heart may not form properly, or pressure from the intruding organs may strain and weaken the heart.
- Lung problems: If the lungs don’t have room to grow and develop, they may be too small to take in enough oxygen at birth. Your baby may have breathing problems or develop pulmonary hypertension. This serious condition causes high blood pressure in the lung’s blood vessels.
- Chromosomal abnormalities or defects: Babies with CDH are more likely to have chromosomal abnormalities, genetic disorders or other birth defects.
Causes of Congenital Diaphragmatic Hernia
CDH has no known cause. Our genetic counselors can help you understand your future risk of having another child with CDH.
Diagnosing Congenital Diaphragmatic Hernia
Our ultrasound experts perform more than 5,000 ultrasound tests every year, giving us special expertise in detecting problems early. During your ultrasound, a maternal-fetal doctor is present to provide information about your unborn baby’s condition and treatment options.
If your doctor suspects CDH, you may need additional tests, such as:
- Fetal magnetic resonance imaging (MRI): This imaging procedure uses a magnetic field (not radiation) to provide detailed information about your unborn baby’s organs, including the heart, lungs and abdomen. This test is safe for your unborn baby.
- Amniocentesis: Your doctor tests a small amount of amniotic fluid to check for chromosomal or genetic disorders.
- Fetal echocardiogram: This ultrasound imaging test assesses the structure and health of your unborn baby’s heart.
Learn more about high-risk pregnancy tests.
Treating Congenital Diaphragmatic Hernia
CDH is a very serious condition. Although survival rates continue to improve, about half of babies born with CDH do not survive. Throughout pregnancy, you undergo regular ultrasounds to monitor development of your baby’s organs, specifically the heart and lungs. After delivery, your child will be cared for through the CDH Clinic until age five.
We recommend that you deliver at a hospital that specializes in high-risk pregnancies, such as the Women & Infants Center. After delivery, your baby receives advanced medical care in our Level IV newborn intensive care unit (NICU). Your baby’s treatment may include:
- Intubation and ventilator: All babies with CDH are intubated (given a breathing tube attached to a ventilator) in the delivery room.
- Inhaled nitric oxide: Your baby breathes in nitric oxide to treat pulmonary hypertension, a major complication of CDH.
- Extracorporeal membrane oxygenation (ECMO): Babies who need extra help breathing may be placed on this advanced heart and lung support system.
- Surgery: Depending on your baby’s medical condition, your baby may undergo surgery soon after birth (or months later) to close the hole in the diaphragm.
To make an appointment with a Washington University fetal care specialist at the Women & Infants Center, call 888.998.3890.