Description

Congenital diaphragmatic hernia (CDH) is a rare condition that occurs in an infant before his birth. Occurs early in the pregnancy, when the baby of the diaphragm, the muscle that separates the chest from the abdomen — fails to close as it should. This leaves a hole in the diaphragm. The hole is called a hernia.

This hernia in the diaphragm muscle creates an opening between the abdomen and the chest. The intestines, the stomach, the liver and other abdominal organs can move through the hole in the chest of the baby. If the bowels are in the chest, do not develop the typical connections that remain in the abdomen (malrotation). You can turn in on itself, cutting off its blood supply (volvulus).

In addition, the lung is small in the side of the diaphragm with herniation, but the development of both lungs are affected. The air sacs (alveoli) in the interior of the lungs do not develop as they should. This results in problems with blood flow and the increase of the pressure inside the lungs, the blood vessels. The pressure of the blood in the lungs is higher than it should be, which can make it difficult for the infant to breathe after birth. Some babies may also have problems with the development of the heart.

The treatment of congenital diaphragmatic hernia depends on when the condition is, how severe it is and if there are problems with the heart.

Symptoms

Congenital diaphragmatic hernia varies in severity. It can be mild and have little or no effect on the baby, or may be more severe and affects the ability to carry oxygen to the rest of the body.

Babies born with CDH may have:

  • Severe trouble breathing because the lungs are not working well (pulmonary hypoplasia).
  • A type of high blood pressure that affects arteries in the lungs and in the right side of the heart (pulmonary hypertension).
  • Problems with the development of the heart.
  • Damage to the intestines, the stomach, the liver and other abdominal organs if it moves through the hernia in the chest.

When to see a doctor

Congenital diaphragmatic hernia may be found during a routine fetal ultrasound. Your health care provider can discuss the treatment options with you.

Causes

In the majority of cases, the cause of congenital diaphragmatic hernia is not known. In some cases, the congenital diaphragmatic hernia can be linked to a genetic disorder or random changes in genes called mutations. In these cases, the baby may have more problems at birth, such as problems with the heart, the eyes, the arms and the legs or the stomach and intestines.

Complications

Complications that can occur with CDH include:

  • Lung problems.
  • Stomach, intestine, and liver problems.
  • Diseases of the heart.
  • The recurrent infections.
  • The hearing loss.
  • Changes in the shape of the chest and the curve of the spine.
  • Disease by reflux of acid from the stomach flowing back into the tube called the esophagus, which connects the mouth to the stomach.
  • Problems with growth and weight gain.
  • Developmental delays and learning disabilities.
  • Other problems present from birth.

Diagnosis

Congenital diaphragmatic hernia is most often found during a routine fetal ultrasound examination which is performed before your baby is born. Prenatal ultrasound uses sound waves to make images of your uterus and the baby.

At times, the diagnosis can't be made until after the birth. Rarely, the HRC may not be diagnosed until childhood or later. This may be due to that there are no signs or symptoms or because the symptoms and signs such as respiratory and intestinal problems are mild.

Symptoms and treatment of Congenital diaphragmatic hernia (CDH)