What is a congenital diaphragmatic hernia?

Congenital diaphragmatic hernia is a clinical condition that concerns developmental flaws in different diaphragm locations. CDH causes abdominal contents (liver, stomach, intestines) to herniate in the thoracic cavity. It results in defects in pulmonary vascular, lung hypoplasia etc. The condition is prevalent in approximately 1-4/10,000 live births. The risk of developing the condition is higher in males.

Types of Congenital diaphragmatic hernia

There are 4 basic types of hernias based on the defective location in the diaphragm.

Bochdalek or Posterolateral hernia

The defect location appears on the diaphragm's postero-lateral region. It majorly occurs on the left body portion. The risk of Bochdalek hernia occurrence is 70-75%. Thus, it is known as the most common type of congenital diaphragmatic hernia.

Morgagni hernia

The condition occurs when the defect appears on the diaphragm's anteromedial region. It accounts for up to 20-25% of patients.

Central hernia

Only 2-5% of congenital diaphragmatic hernia patients develop Central hernia. It is generally the result of an unsatisfactory prognosis. However, the chances of occurrence are very rare.

Acquired diaphragmatic hernia

The condition arises when the diaphragm encounters some trauma.

Causes of Congenital diaphragmatic hernia

The exact causes of CDH are not known. However, close observation of most individuals with CDH shows that their diaphragm defect was genetic. Researchers believe that congenital diaphragmatic hernias may result from abnormalities in the infant’s genes.

Symptoms of Congenital diaphragmatic hernia

Below are some common signs you can check to detect if your infant has CDH:

If the infant is breathing very fast or using extra muscles to breathe properly.
If the baby’s skin colour is showing a bluish tint
Baby’s belly is seemingly very flat, and the chest gains a barrel shape.

Possible complications of CDH

Infants suffering from a congenital diaphragmatic hernia can develop long-term health issues. However, regular consulting with medical professionals helps maintain the condition. It can cause respiratory, Gastrointestinal and other Neurocognitive-related complications. Some common health issues due to CDH are as follows:

Aspiration pneumonia
Chronic lung disease
Obstructive airway disease
Home oxygen requirement
Pulmonary hypertension
Gastroesophageal reflux
Oral feeding aversion,
Gastroesophageal reflux
Growth failure
Sensorineural hearing loss
Behavioural disorders,
Orthopaedic deformities such as scoliosis, pectus, and asymmetrical chest wall

When should you see a doctor?

Congenital diaphragmatic hernia can be fatal for unborn infants and is considered a clinical emergency. If you experience a sudden and consistent stomach expansion, visit a qualified doctor immediately. Timely and effective management of CDH reduces the infant mortality risk and provides a positive prognosis.

Remedies/ Treatments

Medical professionals perform a series of treatments for CDH patients. If you suffer from the condition, take a detailed ultrasound test to learn if your unborn baby also has CDH. Once confirmed, you will go through the following treatment procedures:

Antenatal management

It refers to the close observation of fetal well-being. It includes occlusion of the fetal trachea by an inflated balloon. It is kept under endoscopic visualisation for 26 to 30 weeks gestation.

Postnatal management

It delays the infant’s delivery before 37 weeks of gestation to avoid mortality risk.

Delivery room management

A nasogastric tube is placed for intestines and stomach decompression right after delivery. Doctors follow neonatal resuscitation program (NRP) guidelines for delivery room management.

Ventilator Management

The procedure involves gentle ventilation strategies to avoid ventilator-induced lung injury. This treatment applies to infants with respiratory issues.

Request an appointment at Apollo Cradle, DELHI-NCR - Chirag Enclave. Call 1860-500-4424 to book an appointment.

1. Which type of congenital diaphragmatic hernia is most common?

The majority of expecting mothers and infants develop Bochdalek hernia.

2. Can congenital diaphragmatic hernia reoccur after treatment?

Recurrence of CDH in patients is quite common and can happen after months and years of treatments. Infants with larger defects in the diaphragm are at high risk of developing CDH again.

3. Will congenital diaphragmatic hernia reduce the quality of life?

Infants with CDH are often forced to live with respiratory, gastrointestinal and neurocognitive health issues. However, some studies have also found that infants born with CDH can lead an overall good quality of life health-wise.

4. Can you prevent the occurrence of CDH?

The causes of CDH are unknown. Thus, there is no knowledge base for the condition's origin on which researchers can create prevention methods. However, regular follow-up with treatments helps lead a normal life.

5. Can you physically feel a congenital diaphragmatic hernia?

CDH does not cause any pain until the hernia gets larger. However, you can feel the bulge while coughing, straining or standing up.