Overview
Congenital diaphragmatic hernia (CDH) is a rare condition that occurs during fetal development. It arises when the diaphragm, the muscle separating the chest from the abdomen, fails to close properly. This results in a hole in the diaphragm, allowing abdominal organs to move into the chest cavity. CDH can significantly impact lung development and overall health.
Types of Congenital Diaphragmatic Hernia (CDH)
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Bochdalek Hernia:
- Location: Commonly occurs on the left side (75-90%).
- Characteristics: Large, posterolateral hernia.
- Outcome: Associated with poorer outcomes and presents earlier.
- Mnemonic: Remember as “BBBBB.”
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Morgagni Hernia:
- Location: Less common, anterior hernia.
- Characteristics: Smaller and presents later.
- Associations: Often found behind the sternum (breastbone) and slightly to the right side.
Causes of Congenital Diaphragmatic Hernia (CDH)
- The exact cause of CDH remains unknown.
- Possible factors include genetic mutations, environmental influences, and disruptions during embryonic diaphragm development.
Risk Factors of Congenital Diaphragmatic Hernia (CDH)
- Male sex: CDH is more common in males.
- Maternal age: Older maternal age may increase the risk.
Symptoms of Congenital Diaphragmatic Hernia (CDH)
1. Bluish skin color (cyanosis) due to low oxygen levels.
2. Fast breathing and heart rate.
3. Abnormal chest development (asymmetry).
4. Caved-in abdomen.
5. Vomiting.
6. Difficulty breathing.
7. Noisy sounds with each breath.
Preventions of Congenital Diaphragmatic Hernia (CDH)
Unfortunately, there are no specific preventive measures for CDH due to its multifactorial nature.
Diagnosis of Congenital Diaphragmatic Hernia (CDH)
- Plain Radiograph:
- Indistinct diaphragm with opacification of part or all of the hemithorax (typically left-sided).
- Scaphoid abdomen.
- Deviation of lines (endotracheal tube, nasogastric tube, umbilical catheters).
- Antenatal Ultrasound:
- Polyhydramnios.
- Cardiomediastinal shift.
- Absent bowel loops in the abdomen.
- Intrathoracic herniation of the liver.
- Reduced abdominal circumference.
- Inability to demonstrate the normal stomach bubble.
Treatment for Congenital Diaphragmatic Hernia (CDH)
- Surgical Repair: Most cases require surgical correction.
- Neonatal Intensive Care: Supportive care for respiratory distress.
When to seek medical attention ?
Seek immediate medical attention if your newborn exhibits symptoms such as difficulty breathing, bluish skin, or abnormal chest appearance.
