What is a congenital diaphragmatic hernia?

A hole in the part of the diaphragm, the delicate muscular membrane that separates the chest from the belly, causes a congenital diaphragmatic hernia (CDH). When this breach forms during a fetus' development in the womb, the colon, stomach, and even the liver may flow into the chest cavity. The placement of these abdominal organs in the chest limits lung space and may result in respiratory problems. Because CDH causes the lungs to become compressed, some aspects of how the lungs work may be revealed only after treatment.

What causes CDH?

An embryo's diaphragm is entirely developed by 10 weeks duration of gestation. The mechanism which leads to the creation of the diaphragm is disturbed in the case of CDH. Abdominal fluids may spill into the chest if the diaphragm is injured. This is referred to as herniation. Because of increasing fetal movement and respiratory movements, the degree of herniation may fluctuate or worsen as the pregnancy develops.

A chromosomal defect or a hereditary disease can occasionally cause CDH. In this case, the child may have further medical issues or organ anomalies. CDH can arise without a known familial foundation in some circumstances. The main concern in these cases is the degree of pulmonary hypoplasia caused by the condition, known as isolated CDH. Genetic testing is required to determine whether CDH is isolated and to provide the most exact information about the disorder.

Symptoms/ Signs

The symptoms or signs can vary from child to child and below listed are the symptoms that are observed :

Slight difficulty in breathing.
Breathing fast.
High Heart rate.
There will be some unusual chest development in which one side is more significant compared to the other one.
Difference in Abdomen

A Morgagni hernia in a newborn may or may not cause symptoms. The likelihood of another congenital disorder being present at birth is higher in infants with Bochdalek CDH.

How is a congenital diaphragmatic hernia diagnosed?

An ultrasound can identify or rule out the presence of a diaphragmatic hernia. When CDH is discovered or suspected during pregnancy, our physicians will coordinate care through the Maternal Foetal Care Center. As part of the assessment, the below-mentioned tests are conducted to determine the presence and severity of a CDH:

A CDH, as well as other abnormalities, can be detected using ultrasound.
By scanning the chest part and abdomen in more depth and analyzing lung development, fetal MRI can help to figure out the seriousness of the condition and detect any other relevant defects.
A fetal echocardiogram is a heart ultrasound that searches for cardiac abnormalities, which are common in CDH patients.

Following the completion of all essential tests, our professionals convene to review and discuss their findings. After, they will meet you in person to discuss the result of the diagnosis and to decide the best treatment that suits you. When CDH is not found before birth, it is usually discovered during the neonatal period when the newborn has breathing problems. In rare cases, it is detected later in childhood or adolescence, more typically, Morgagni-type CDH.

The below-mentioned tests are frequently performed:

The Chest part will be examined through an x-ray which analyses the lung, intestine issues and the diaphragm.
An echocardiogram can offer you further information about your child's health.
An arterial blood test is widely performed to assess your baby's capacity to breathe.
Usual blood tests are performed to determine whether a genetic condition occurs.

It is always best to consult a medical professional to treat the congenital diaphragm properly and as effectively as possible.

Request an appointment at Apollo Cradle, Bengaluru - Koramangala. Call 1860-500-4424 to book an appointment.

1. What is the sequence of events immediately following the birth of a CDH baby?

An infant with CDH is immediately handed over to the Newborn/Infant Stabilization Team in the adjacent SDU resuscitation room via a "pass-through" window. These rooms are specifically designed to deliver babies requiring immediate care.

2. What factors determine that the newborn is ready for CDH repair?

Operating on a healthy infant is safer than operating on one who is very sick. Stability is affected by the level of pulmonary hypertension, blood pressure, blood gases, ventilator settings and diuresis.

3. What should I keep in mind when feeding a CDH baby?

We encourage breastfeeding in addition to teaching you how to pump breast milk. The milk is stored frozen until the infant is ready to start eating. Milk is supplied through a tiny tube into the infant's stomach until the youngster is ready to begin eating by mouth.

4. How can I help my infant while he or she is in hospital?

You can talk to, hold, and touch your newborn after he or she has been pronounced medically safe for contact. Once your baby is stable, you will be encouraged to change his or her diapers, bathe and clothe him or her, and finally learn everything you need to know to prepare your baby for the discharge process.

5. How long will a newborn with CDH stay in hospital?

Although it varies on your child, a CDH newborn often stays under examination for two to three months. Compared to other newborns, those who need ECMO or who have chronic pulmonary hypertension may need longer hospital stays.