Congenital Diaphragmatic Hernia (CDH) is a birth defect in which the diaphragm does not form properly. The expert perinatologists, pediatric surgeons and neonatologists of the Center for Maternal Fetal Health at Rocky Mountain Hospital for Children, Denver are specially trained to diagnose and treat this rare condition. In addition, our staff and facility are uniquely equipped to handle the careful treatment of your baby’s health during pregnancy as well as during and after birth.
About Congenital Diaphragmatic Hernia
A baby with Congenital Diaphragmatic Hernia (CDH) has a hole in his/her diaphragm. The diaphragm is a thin layer of muscle essential for breathing that forms early in pregnancy—usually between weeks eight and 10 of gestation. This muscle also separates the abdomen and the chest keeping vital organs in place. Because of the breach in the diaphragm, abdominal organs come through the hernia into the chest, taking up lung space, preventing the lungs from developing correctly. The condition occurs in an estimated 1 in 3,000 live births. The cause is unknown, but a third of babies with CDH have other birth defects, including heart defects.
Congenital Diaphragmatic Hernia Diagnosis
CDH usually is diagnosed during a routine prenatal ultrasound. Once the condition is suspected, perinatologists (obstetricians who specialize in high risk pregnancies) often order additional tests such as a fetal MRI and a fetal echocardiogram (an ultrasound of the heart) to gain as much information about the baby’s specific needs prior to birth. Some babies are not diagnosed until shortly after birth when the baby has trouble breathing. After birth, all babies with CDH typically undergo a chest X-ray and blood tests (arterial blood gas, chromosome).
Congenital Diaphragmatic Hernia Treatment
Babies who have been diagnosed with CDH are carefully monitored during pregnancy and a plan for delivery at a specialized facility is arranged. Most babies with CDH do not require a Cesarean section for delivery. However, many CDH babies require a ventilator or ECMO (extracorporeal membrane oxygenation) after birth. Therefore, it is important to plan delivery at a hospital specially equipped with a Level IV NICU, perinatologists, neonatologists, expert pediatric surgeons and experienced staff. Complications of this condition include pneumothorax (collapsed lung), pulmonary hypertension (increased blood pressure in lung circulation), respiratory failure or need for ECMO. After birth, the baby is stabilized and surgery is planned. The expert surgeons of Rocky Mountain Pediatric Surgery use a thoracoscopic (minimally invasive) approach to move the displaced organs back to the abdomen and repair the hole. Our team has more than 20 years of experience and has cared for 30 newborns in the last five years with this rare condition. Only 1 percent of these patients have required ECMO (heart-lung bypass). To contact the leading edge surgeons at Rocky Mountain Pediatric Surgery, please call 303-839-6001.
Long-Term Outlook for Congenital Diaphragmatic Hernia
Babies with CDH often require long term follow up care. Complications can include GERD (gastrointestinal esophageal reflux disease), developmental delays, chronic lung disease, hearing loss, asthma and/or failure to thrive. Our team provides careful monitoring, treatment and follow up care to allow CDH babies to live happy, full lives.
To find an expert perinatologist or pediatric surgeon, contact our program care coordinator at 720-754-4902.