Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-27T14:19:04.499Z Has data issue: false hasContentIssue false

Chapter 19.2 - Congenital diaphragmatic hernia

clinical antenatal management

from Section 2 - Fetal disease

Published online by Cambridge University Press:  05 February 2013

By
Jan Deprest ,
Jaan Toelen ,
Philip De Koninck ,
Jute Richter ,
Alexander Engels ,
Paul Brady ,
Kypros Nicolaides ,
Eduard Gratacos ,
Filip Claus  and
Dick Tibboel
...Show all authors
Edited by
Mark D. Kilby ,
Anthony Johnson  and
Dick Oepkes
Mark D. Kilby
Affiliation:
Department of Fetal Medicine, University of Birmingham
Anthony Johnson
Affiliation:
Baylor College of Medicine, Texas
Dick Oepkes
Affiliation:
Department of Obstetrics, Leiden University Medical Center
Get access

Summary

Introduction

Congenital diaphragmatic hernia (CDH) is a congenital birth defect which occurs in 1 in 3000 to 1 in 5000 live births [1]. This number discounts what has been called the “hidden mortality,” i.e., stillbirths or neonatal deaths before transfer to a tertiary care center. Probably a more accurate estimate incidence of CDH is 1 in 2200 live births [2, 3]. Based on 5 420 900 live births in the European Union (EU-27) counted by Eurostat (2008), this means in absolute numbers at least every 4 hours one new case is born alive! According to a meta-analysis, up to 40% of cases have associated problems [4]. These can occur in the absence or presence of identified syndromes or other genetic problems. The presence of other anomalies is an independent predictor of neonatal death. The majority thus are apparently isolated and they are the actual subject of this contribution. The introduction of maternal ultrasound screening programs today lead to prenatal diagnosis in about two out of three cases, hence prenatal management options [5].

Herein we will discuss CDH from a perspective of antenatal management, including fetal intervention. Fetal surgery is only contemplated when five conditions are present, as defined by the International Fetal Medicine and Surgery Society (IFMSS) [6] (Table 19.2.1). We will discuss how this applies to CDH. We first summarize actual survival rates when this condition is managed after birth, essentially showing that there is no effective postnatal therapy in a subset of fetuses. In other words, the natural history of CDH has been identified (condition 2) and for some cases there is no effective postnatal therapy (condition 3). Key to fetal therapy is the fulfillment of condition 1, which means that there must be methods to tie the first two conditions together and have assessment methods that can predict poor outcome despite optimal postnatal care. We will summarize how such individualized prognosis can be made. Then we will summarize the experimental basis for fetal surgery (condition 4). Given all this, fetal therapy for CDH became a clinical reality. We describe the current clinical experience with fetal surgery, including the design of trials that will have to determine the place of fetal surgery (condition 5).

Keywords

MRIfetal surgeryfetal endoscopic tracheal occlusiongestational ageprenatal imagingthree-dimensional ultrasounddiffusion-weighted imagingantenatal managementcongenital diaphragmatic hernia
Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
 , pp. 376 - 388
Publisher: Cambridge University Press
Print publication year: 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Butler N, Claireaux AE, Congenital diaphragmatic hernia as a cause of perinatal mortality. Lancet 1962;1(7231):659–63.Google Scholar
Harrison, MR, Bjordal, RI, Langmark, F, Kruturd, O. Congenital diaphragmatic hernia: the hidden mortality. J Pediatr Surg 1978;13(3):227–30.Google Scholar
Langham, MR Jr., Kays, DW, Ledbetter, DJ, et al. Congenital diaphragmatic hernia. Epidemiology and outcome. Clin Perinatol 1996;23(4):671–88.Google Scholar
Slavotinek, AM. The genetics of congenital diaphragmatic hernia. Semin Perinatol 2005;29(2):77–85.Google Scholar
Garne, E, Haeusler, M, Barisic, , et al. Congenital diaphragmatic hernia: evaluation of prenatal diagnosis in 20 European regions. Ultrasound Obstet Gynecol 2002;19(4):329–33.Google Scholar
Harrison, MR, Filly, RA, Golbus, MS. Fetal treatment 1982. N Engl J Med 1982;307(26):1651–2 .Google Scholar
Moya, FR, Lally, KP. Evidence-based management of infants with congenital diaphragmatic hernia. Semin Perinatol 2005;29(2):112–17.Google Scholar
Stege, G, Fenton, A, Jaffray, B. Nihilism in the 1990s: the true mortality of congenital diaphragmatic hernia. Pediatrics 2003;112(3 Pt 1):532–5.Google Scholar
Gallot, D, Boda, C, Ughetto, S, et al. Prenatal detection and outcome of congenital diaphragmatic hernia: a French registry-based study. Ultrasound Obstet Gynecol 2007;29(3):276–83.Google Scholar
Hedrick, HL, Danzer, E, Merchant, A, et al. Liver position and lung-to-head ratio for prediction of extracorporeal membrane oxygenation and survival in isolated left congenital diaphragmatic hernia. Am J Obstet Gynecol 2007;197(4):422.e1–4.Google Scholar
Datin-Dorriere, V, Rouzies, S, Taupin, P, et al. Prenatal prognosis in isolated congenital diaphragmatic hernia. Am J Obstet Gynecol 2008;198(1):80.e1–5.Google Scholar
Sartoris, J, Varnholt, V, Dahlheim, D, Schaible, T. CDH in Mannheim – algorithm and results. Monatschr Kinderheilkd 2006;153:717.Google Scholar
Mettauer, NL, Pierce, CM, Cassidy, JV, Kiely, EM, Petros, AJ. One-year survival in congenital diaphragmatic hernia, 1995–2006. Arch Dis Child 2009;94(5):407.Google Scholar
Grushka, JR, Laberge, JM, Puligandla, P et al. Effect of hospital case volume on outcome in congenital diaphragmatic hernia: the experience of the Canadian Pediatric Surgery Network. J Pediatr Surg 2009;44(5):873–6.Google Scholar
Deprest, JA, Flake, AW, Gratacos, E, et al. The making of fetal surgery. Prenat Diagn 2010;30(7):653–67.Google Scholar
Gischler, SJ, Mazer, P, Duivenvoorden, HJ, et al. Interdisciplinary structural follow-up of surgical newborns: a prospective evaluation. J Pediatr Surg 2009;44(7):1382–9.Google Scholar
Bagolan, P, Morini, F. Long-term follow up of infants with congenital diaphragmatic hernia. Semin Pediatr Surg 2007;16(2):134–44.Google Scholar
Trachsel, D, Selvadurai, H, Bohn, D, Langer, JC, Coates, AC. Long-term pulmonary morbidity in survivors of congenital diaphragmatic hernia. Pediatr Pulmonol 2005;39(5):433–9.Google Scholar
Peetsold, MG, Heij, H, Kreepkens, CM, et al. The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity. Pediatr Surg Int 2009;25(1):1–17.Google Scholar
Marven, SS, Smith, CM, Claxton, D, et al. Pulmonary function, exercise performance, and growth in survivors of congenital diaphragmatic hernia. Arch Dis Child 1998;78(2):137–42.Google Scholar
Peetsold, MG, Heij, HA, Nagelkerke, AF, et al. Pulmonary function and exercise capacity in survivors of congenital diaphragmatic hernia. Eur Respir J 2009;34(5):1140–7.Google Scholar
Falconer, AR, Brown, RA, Helms, P, Gordon, I, Baron, JA. Pulmonary sequelae in survivors of congenital diaphragmatic hernia. Thorax 1990;45(2):126–9.Google Scholar
Kamata, S, Usui, N, Kamiyama, M, et al. Long-term follow-up of patients with high-risk congenital diaphragmatic hernia. J Pediatr Surg 2005;40(12):1833–8.Google Scholar
Marven, SS, Smith, CM, Claxton, D, et al. Pulmonary function, exercise performance, and growth in survivors of congenital diaphragmatic hernia. Arch Dis Child 1998;78(2):137–42.Google Scholar
Vanamo, K, Peltonen, J, Rintala, R, et al. Chest wall and spinal deformities in adults with congenital diaphragmatic defects. J Pediatr Surg 1996;31(6):851–4.Google Scholar
Kantarci, S, Donahoe, PK. Congenital diaphragmatic hernia (CDH) etiology as revealed by pathway genetics. Am J Med Genet C Semin Med Genet 2007;145C(2):217–26.Google Scholar
Scott, DA, Klaassens, M, Holder, AM, et al., Genome-wide oligonucleotide-based array comparative genome hybridization analysis of non-isolated congenital diaphragmatic hernia. Hum Mol Genet 2007;16(4):424–30.Google Scholar
Brady, PD, Srisupundit, K, Dewiendt, K, et al. Recent developments in the genetic factors underlying congenital diaphragmatic hernia. Fetal Diagn Ther 2010;29(1):25–39.Google Scholar
Srisupundit, K, Brady, PD, Devriendt, K, et al. Targeted array comparative genomic hybridisation (array CGH) identifies genomic imbalances associated with isolated congenital diaphragmatic hernia (CDH). Prenat Diagn 2010;30(12–13):1198–206.Google Scholar
Miller, DT, Adam, MO, Aradhya, S, et al. Consensus statement: chromosomal microarray is a first-tier clinical diagnostic test for individuals with developmental disabilities or congenital anomalies. Am J Hum Genet 2010;86(5):749–64.Google Scholar
Shaikh, TH, Gai, X, Perin, JC, et al. High-resolution mapping and analysis of copy number variations in the human genome: a data resource for clinical and research applications. Genome Res 2009;19(9):1682–90.Google Scholar
Metkus, AP, Filly, RA, Stinger, MD, Harrison, MR, Adzick, NS. Sonographic predictors of survival in fetal diaphragmatic hernia. J Pediatr Surg 1996;31(1):148–51; discussion 151–2.Google Scholar
Peralta, CF, Cavoretto, P, Csapo, B, Vandecruys, H, Nicolaides, KH. Assessment of lung area in normal fetuses at 12–32 weeks. Ultrasound Obstet Gynecol 2005;26(7):718–24.Google Scholar
Jani, J, Peralta, CF, Benachi, A, Deprest, J, Nicolaides, KH. Assessment of lung area in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2007;30(1):72–6.Google Scholar
Cruz-Martinez, R, Figueras, F, Jaramillo, JJ, et al., Learning curve for Doppler measurement of fetal modified myocardial performance index. Ultrasound Obstet Gynecol 2011;37(2):158–62.Google Scholar
Claus, F, Samdaite, I, DeKoninck, P, et al. Prenatal anatomical imaging in fetuses with congenital diaphragmatic hernia. Fetal Diagn Ther 2011;29(1):88–100.Google Scholar
Jani, J, Nicolaides, K, Keller, RL, et al. Observed to expected lung area to head circumference ratio in the prediction of survival in fetuses with isolated diaphragmatic hernia. Ultrasound Obstet Gynecol 2007;30(1):67–71.Google Scholar
Jani, JC, Benachi, A, Nicolaides, KH, et al. Prenatal prediction of neonatal morbidity in survivors with congenital diaphragmatic hernia: a multicenter study. Ultrasound Obstet Gynecol 2009;33(1):64–9.Google Scholar
Deprest, JA,Flemmer, AW,Gratacos, E,Nicolaides, K. An tenatal prediction of lung volume and in-utero treatment by fetal endoscopic tracheal occlusion in severe isolated congential diaphroynative hernia. Semin Fetal Neonatal Med 2009;14(1):8–13.
Jani, J, Nicolaides, KH, Benachi, S, et al. Timing of lung size assessment in the prediction of survival in fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol 2008;31(1):37–40.Google Scholar
Alfaraj, MA, Shah, PS, Bohn, D, et al. Congenital diaphragmatic hernia: lung-to-head ratio and lung volume for prediction of outcome. Am J Obstet Gynecol 2011;205(1):43.e1–8.Google Scholar
Knox, E, Lissauer, D, Khan, K, Killoy, M. Prenatal detection of pulmonary hypoplasia in fetuses with congenital diaphragmatic hernia: a systematic review and meta-analysis of diagnostic studies. J Matern Fetal Neonatal Med 2010;23(7):579–88.Google Scholar
Jani, JC, Cannie, M, Peralta, CF, et al. Lung volumes in fetuses with congenital diaphragmatic hernia: comparison of 3D US and MR imaging assessments. Radiology 2007;244(2):575–82.Google Scholar
Ruano, R, Aubry, MC, Durnez, Y, Zugaib, M, Benachi, A. Predicting neonatal deaths and pulmonary hypoplasia in isolated congenital diaphragmatic hernia using the sonographic fetal lung volume-body weight ratio. AJR Am J Roentgenol 2008;190(5):1216–19.Google Scholar
Ruano, R, Joubin, L, Sonigo, P, et al. Fetal lung volume estimated by 3-dimensional ultrasonography and magnetic resonance imaging in cases with isolated congenital diaphragmatic hernia. J Ultrasound Med 2004;23(3):353–8.Google Scholar
Walsh, DS, Hubbard, AM, Olutaye, OO, et al. Assessment of fetal lung volumes and liver herniation with magnetic resonance imaging in congenital diaphragmatic hernia. Am J Obstet Gynecol 2000;183(5):1067–9.Google Scholar
Cannie, MM, Jami, JC, Van Kerkhove, F, et al. Fetal body volume at MR imaging to quantify total fetal lung volume: normal ranges. Radiology 2008;247(1):197–203.Google Scholar
Cannie, M, Jani, J, Meersschaert, J, et al. Prenatal prediction of survival in isolated diaphragmatic hernia using observed to expected total fetal lung volume determined by magnetic resonance imaging based on either gestational age or fetal body volume. Ultrasound Obstet Gynecol 2008;32(5):633–9.Google Scholar
Jani, J, Cannie, M, Sonigo, P, et al. Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol 2008;32(6):793–9.Google Scholar
Walsh, DS, Hubbard, AM, Olutaye, OO, et al. Assessment of fetal lung volumes and liver herniation with magnetic resonance imaging in congenital diaphragmatic hernia. Am J Obstet Gynecol 2000;183(5):106–9.Google Scholar
Cannie, M, Jani, J, Chaffiotte, C, et al. Quantification of intrathoracic liver herniation by magnetic resonance imaging and prediction of postnatal survival in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2008;32(5):627–32.Google Scholar
Mayer, S, Klaritsch, P, Petersen, S, et al. The correlation between lung volume and liver herniation measurements by fetal MRI in isolated congenital diaphragmatic hernia: a systematic review and meta-analysis of observational studies. Prenat Diagn 2011;31(11):1086–96.Google Scholar
Sokol, J, Shimizu, N, Bohn, D, et al. Fetal pulmonary artery diameter measurements as a predictor of morbidity in antenatally diagnosed congenital diaphragmatic hernia: a prospective study. Am J Obstet Gynecol 2006;195(2):470–7.Google Scholar
Ruano, R, de Fátima Yukie Maeda, M, Niigaki, JI, Zugaib, M. Pulmonary artery diameters in healthy fetuses from 19 to 40 weeks’ gestation. J Ultrasound Med 2007;26(3):309–16.Google Scholar
Ruano, R, Aubry, MC, Barthe, B, et al. Quantitative analysis of fetal pulmonary vasculature by 3-dimensional power Doppler ultrasonography in isolated congenital diaphragmatic hernia. Am J Obstet Gynecol 2006;195(6):1720–8.Google Scholar
Moreno-Alvarez, O, Cruz-Martinez, R, Hernandez-Andrade, E, et al. Lung tissue perfusion in congenital diaphragmatic hernia and association with the lung-to-head ratio and intrapulmonary artery pulsed Doppler. Ultrasound Obstet Gynecol 2010;35(5):578–82.Google Scholar
Moreno-Alvarez, O, Hernandez-Andrade, E, Oros, D, et al. Association between intrapulmonary arterial Doppler parameters and degree of lung growth as measured by lung-to-head ratio in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2008;31(2):164–70.Google Scholar
Cannie, M, Jani, J, De Keyzer, F, et al., Diffusion-weighted MRI in lungs of normal fetuses and those with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2009;34(6):678–86.Google Scholar
Clugston, RD, Klattig, J, Englert, C, et al. Teratogen-induced, dietary and genetic models of congenital diaphragmatic hernia share a common mechanism of pathogenesis. Am J Pathol 2006;169(5):1541–9.Google Scholar
Noble, BR, Babiuk, RP, Clugston, RD, et al. Mechanisms of action of the congenital diaphragmatic hernia-inducing teratogen nitrofen. Am J Physiol Lung Cell Mol Physiol 2007;293(4):L1079–87.Google Scholar
Haller, JA Jr, Signer, RD, Golladay, ES, et al. Pulmonary and ductal hemodynamics in studies of simulated diaphragmatic hernia of fetal and newborn lambs. J Pediatr Surg 1976;11(5):675–80.Google Scholar
Adzick, NS, Outwater, KM, Harrison, MR, et al. Correction of congenital diaphragmatic hernia in utero. IV. An early gestational fetal lamb model for pulmonary vascular morphometric analysis. J Pediatr Surg 1985;20(6):673–80.Google Scholar
DiFiore, JW, Fauza, DO, Slavin, R, et al. Experimental fetal tracheal ligation reverses the structural and physiological effects of pulmonary hypoplasia in congenital diaphragmatic hernia. J Pediatr Surg 1994;29(2):248–56; discussion 256–7.Google Scholar
Karamanoukian, HL, O’Toole, SJ, Rossman, JR, et al. Fetal surgical interventions and the development of the heart in congenital diaphragmatic hernia. J Surg Res 1996;65(1):5–8.Google Scholar
Areechon W, Eid L. Hypoplasia of lung with congenital diaphragmatic hernia. Br Med J 1963;1(5325):230–3.Google Scholar
Harrison, MR, Bressack, MA, Churg, AM, de Lorimier, AA. Correction of congenital diaphragmatic hernia in utero. II. Simulated correction permits fetal lung growth with survival at birth. Surgery 1980;88(2):260–8.Google Scholar
Harrison, MR, Adzick, NS, Longaker, MT, et al. Successful repair in utero of a fetal diaphragmatic hernia after removal of herniated viscera from the left thorax. N Engl J Med 1990;322(22):1582–4.Google Scholar
Esteve, C, Toubas, F, Gaudiche, O, et al. [Evaluation of 5 years of experimental in utero surgery for the repair of diaphragmatic hernia]. Ann Fr Anesth Reanim 1992;11(2):193–200.Google Scholar
Harrison, MR, Adzick, NS, Flake, AW, et al. Correction of congenital diaphragmatic hernia in utero: VI. Hard-earned lessons. J Pediatr Surg 1993;28(10):1411–17; discussion 1417–18.Google Scholar
Carmel, JA, Friedman, F, Adams, FH. Fetal tracheal ligation and lung development. Am J Dis Child 1965;109:452–6.Google Scholar
Harding, R, Bocking, AD, Sigger, JN. Upper airway resistances in fetal sheep: the influence of breathing activity. J Appl Physiol 1986;60(1):160–5.Google Scholar
Vilos, GA, Liggins, GC. Intrathoracic pressures in fetal sheep. J Dev Physiol 1982;4(4):247–56.Google Scholar
Fewell, JE, Johnson, P. Upper airway dynamics during breathing and during apnoea in fetal lambs. J Physiol 1983;339:495–504.Google Scholar
Harding, R, Bocking, AD, Sigger, JN. Influence of upper respiratory tract on liquid flow to and from fetal lungs. J Appl Physiol 1986;61(1):68–74.Google Scholar
Liggins, GC. Growth of the fetal lung. J Dev Physiol 1984;6(3):237–48.Google Scholar
Moessinger, AC. Lung hypoplasia and polyhydramnios found in association with congenital diaphragmatic hernia. J Pediatr Surg 1990;25(12):1307–8.Google Scholar
Alcorn, D, Adamson, TM, Lambert, TF, et al. Morphological effects of chronic tracheal ligation and drainage in the fetal lamb lung. J Anat 1977;123(Pt 3):649–60.Google Scholar
Evrard, VA, Flageole, H, Deprest, JA, et al. Intrauterine tracheal obstruction, a new treatment for congenital diaphragmatic hernia, decreases amniotic fluid sodium and chloride concentrations in the fetal lamb. Ann Surg 1997;226(6):753–8.Google Scholar
Hedrick, MH, Estes, JM, Sullivan, KM, et al. Plug the lung until it grows (PLUG): a new method to treat congenital diaphragmatic hernia in utero. J Pediatr Surg 1994;29(5):612–17.Google Scholar
Harrison, MR, Adzick, NS, Flake, AW, et al. Correction of congenital diaphragmatic hernia in utero VIII: Response of the hypoplastic lung to tracheal occlusion. J Pediatr Surg 1996;31(10):1339–48.Google Scholar
Bealer, JF, Skarsgard, ED, Hedrick, MH, et al. The ‘PLUG’ odyssey: adventures in experimental fetal tracheal occlusion. J Pediatr Surg 1995;30(2):361–4; discussion 364–5.Google Scholar
Luks, FI, Gilchrist, BF, Jackson, BT, Piasecki, GJ. Endoscopic tracheal obstruction with an expanding device in a fetal lamb model: preliminary considerations. Fetal Diagn Ther 1996;11(1):67–71.Google Scholar
Benachi, A, Delezoide, AL, Chailley-Heu, B, et al. Ultrastructural evaluation of lung maturation in a sheep model of diaphragmatic hernia and tracheal occlusion. Am J Respir Cell Mol Biol 1999;20(4):805–12.Google Scholar
Evrard, VA, Verbeken, EA, Vanderberghe, K, et al. Endoscopic in utero tracheal plugging in the fetal lamb to treat congenital diaphragmatic hernia. J Am Assoc Gynecol Laparosc 1996;3(4 Suppl):S11.Google Scholar
Harrison, MR, Sydorak, RM, Farrell, JA, et al. Fetoscopic temporary tracheal occlusion for congenital diaphragmatic hernia: prelude to a randomized, controlled trial. J Pediatr Surg 2003;38(7):1012–20.Google Scholar
Jani, JC, Nicolaides, KH, Gratacós, E, et al. Severe diaphragmatic hernia treated by fetal endoscopic tracheal occlusion. Ultrasound Obstet Gynecol 2009;34(3):304–10.Google Scholar
Deprest, JA, Evrard, VA, Verbeken, EK, et al. Tracheal side effects of endoscopic balloon tracheal occlusion in the fetal lamb model. Eur J Obstet Gynecol Reprod Biol 2000;92(1):119–26.Google Scholar
Nelson, S, Cameron, A, Deprest, J. Fetoscopic surgery for in utero management of congenital diaphragmatic hernia. Fetal Matern Med Rev 2006;17:69–104.Google Scholar
Khan, PA, Cloutier, M, Piedboeuf, B. Tracheal occlusion: a review of obstructing fetal lungs to make them grow and mature. Am J Med Genet C Semin Med Genet 2007;145C(2):125–38.Google Scholar
Nardo, L, Hooper, SB, Harding, R. Stimulation of lung growth by tracheal obstruction in fetal sheep: relation to luminal pressure and lung liquid volume. Pediatr Res 1998;43(2):184–90.Google Scholar
Piedboeuf, B, Laberge, JM, Ghitulescu, G, et al. Deleterious effect of tracheal obstruction on type II pneumocytes in fetal sheep. Pediatr Res 1997;41(4 Pt 1):473–9.Google Scholar
Hashim, E, Laberge, JM, Chen, MF, Quillen, EW, et al. Reversible tracheal obstruction in the fetal sheep: effects on tracheal fluid pressure and lung growth. J Pediatr Surg 1995;30(8):1172–7.Google Scholar
De Paepe, ME, Johnson, BD, Papadakis, K, Luks, FI. Lung growth response after tracheal occlusion in fetal rabbits is gestational age-dependent. Am J Respir Cell Mol Biol 1999;21(1):65–76.Google Scholar
Keramidaris, E, Hooper, SB, Harding, R. Effect of gestational age on the increase in fetal lung growth following tracheal obstruction. Exp Lung Res 1996;22(3):283–98.Google Scholar
Liao, SL, Luks, FI, Piasecki, GJ, et al. Late-gestation tracheal occlusion in the fetal lamb causes rapid lung growth with type II cell preservation. J Surg Res 2000;92(1):64–70.Google Scholar
Lipsett, J, Cool, JC, Runciman, SC, et al. Morphometric analysis of pulmonary development in the sheep following creation of fetal diaphragmatic hernia. Pediatr Pathol Lab Med 1997;17(5):789–807.Google Scholar
De Paepe, ME, Johnson, BD, Papadakis, K, Sueishi, K, Luks, FI. Temporal pattern of accelerated lung growth after tracheal occlusion in the fetal rabbit. Am J Pathol 1998;152(1):179–90.Google Scholar
O’Toole, SJ, Sharma, A, Karamanoukian, , et al. Tracheal ligation does not correct the surfactant deficiency associated with congenital diaphragmatic hernia. J Pediatr Surg 1996;31(4):546–50.Google Scholar
Flageole, H, Evrard, VA, Piedboeeuf, B, et al. The plug-unplug sequence: an important step to achieve type II pneumocyte maturation in the fetal lamb model. J Pediatr Surg 1998;33(2):299–303.Google Scholar
Nelson, SM, Hajivassiliou, CA, Haddock, G, et al. Rescue of the hypoplastic lung by prenatal cyclical strain. Am J Respir Crit Care Med 2005;171(12):1395–402.Google Scholar
Luks, FI, Wild, YK, Piasecki, GJ, De Paepe, ME. Short-term tracheal occlusion corrects pulmonary vascular anomalies in the fetal lamb with diaphragmatic hernia. Surgery 2000;128(2):266–72.Google Scholar
Davey, MG, Hedrick, HL, Bouchard, S, et al. Temporary tracheal occlusion in fetal sheep with lung hypoplasia does not improve postnatal lung function. J Appl Physiol 2003;94(3):1054–62.Google Scholar
Wu, J, Yamamoto, H, Gratacos, E, et al. Lung development following diaphragmatic hernia in the fetal rabbit. Hum Reprod 2000;15(12):2483–8.Google Scholar
Roubliova, X, Verbeken, E, Wu, J, et al. Pulmonary vascular morphology in a fetal rabbit model for congenital diaphragmatic hernia. J Pediatr Surg 2004;39(7):1066–72.Google Scholar
Roubliova, XI, Deprest, JA, Biard, JM, et al. Morphologic changes and methodological issues in the rabbit experimental model for diaphragmatic hernia. Histol Histopathol 2010;25(9):1105–16.Google Scholar
Roubliova, XI, Deprest, JA, Verbeken, E, et al. The effect of maternal betamethasone and fetal tracheal occlusion on pulmonary vascular morphometry in fetal rabbits with surgically induced diaphragmatic hernia: a placebo controlled morphologic study. Prenat Diagn 2009;29(7):674–81.Google Scholar
Roubliova, XI, Verbeken, E, Wu, J, et al. Effect of tracheal occlusion on peripheric pulmonary vessel muscularization in a fetal rabbit model for congenital diaphragmatic hernia. Am J Obstet Gynecol 2004;191(3):830–6.Google Scholar
Kitano, Y, Davies, P, von Allmen, D, Adzick, NS, Flake, AW. Fetal tracheal occlusion in the rat model of nitrofen-induced congenital diaphragmatic hernia. J Appl Physiol 1999;87(2):769–75.Google Scholar
Kitano, Y, Kanai, M, Davies, P, et al. BAPS prize-1999: Lung growth induced by prenatal tracheal occlusion and its modifying factors: a study in the rat model of congenital diaphragmatic hernia. J Pediatr Surg 2001;36(2):251–9.Google Scholar
Klaritsch, P, Mayer, S, Sbragia, L, et al. Albumin as an adjunct to tracheal occlusion in fetal rats with congenital diaphragmatic hernia: a placebo-controlled study. Am J Obstet Gynecol 2010;202(2):198e1–9.Google Scholar
Muensterer, OJ, Till, H, Bermann, F, et al. Lung growth induced by prenatal instillation of perfluorocarbon into the fetal rabbit lung. Pediatr Surg Int 2004;20(4):248–52.Google Scholar
Muensterer, OJ, Flemmer, AW, Bergmann, F, et al. Postnatal lung mechanics, lung composition, and surfactant synthesis after tracheal occlusion vs prenatal intrapulmonary instillation of perfluorocarbon in fetal rabbits. J Pediatr Surg 2005;40(1):26–31.Google Scholar
Deprest, J, Gratacos, E, Nicolaides, KH. Fetoscopic tracheal occlusion (FETO) for severe congenital diaphragmatic hernia: evolution of a technique and preliminary results. Ultrasound Obstet Gynecol 2004;24(2):121–6.Google Scholar
Deprest, J, Nicolaides, K, Done, E, et al. Technical aspects of fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia. J Pediatr Surg 2011;46(1):22–32.Google Scholar
Harrison, MR, Keler, RL, Hawgood, SB, et al. A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia. N Engl J Med 2003;349(20):1916–24.Google Scholar
Ruano, R, Duarte, SA, Pimenta, EJ, et al. Comparison between fetal endoscopic tracheal occlusion using a 1.0-mm fetoscope and prenatal expectant management in severe congenital diaphragmatic hernia. Fetal Diagn Ther 2011;29(1):64–70.Google Scholar
Peralta, CF, Sbragia, L, Bennini, JR, et al. Fetoscopic endotracheal occlusion for severe isolated diaphragmatic hernia: initial experience from a single clinic in Brazil. Fetal Diagn Ther 2011;29(1):71–7.Google Scholar
Deprest, JA, Nicolaides, K, Gratacos, E. Fetal surgery for congenital diaphragmatic hernia is back from never gone. Fetal Diagn Ther 2011;29(1):6–17.Google Scholar
Done, E, Lewi, P, Rayyan, P, et al. Neonatal morbidity in fetuses with severe isolated congenital diaphragmatic hernia (CDH). Am J Obstet Gynecol 2011;204(1):S33.Google Scholar
Fauza, DO, Marler, JJ, Koka, R, et al. Fetal tissue engineering: diaphragmatic replacement. J Pediatr Surg 2001;36(1):146–51.Google Scholar
Kohl, T, Gembruch, U, Filsinger, B, et al. Encouraging early clinical experience with deliberately delayed temporary fetoscopic tracheal occlusion for the prenatal treatment of life-threatening right and left congenital diaphragmatic hernias. Fetal Diagn Ther 2006;21(3):314–18.Google Scholar
Reiss, I, Schaible, T, van der Hout, L, et al. Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: the CDH EURO Consortium consensus. Neonatology 2010;98(4):354–64.Google Scholar
Deprest, JA, Gratacos, E, Nicolaides, K, et al. Changing perspectives on the perinatal management of isolated congenital diaphragmatic hernia in Europe. Clin Perinatol 2009;36(2):329–47.Google Scholar
Cannie, MM, Jani, JC, De Kezer, F, et al. Evidence and patterns in lung response after fetal tracheal occlusion: clinical controlled study. Radiology 2009;252(2):526–33.Google Scholar
van den Hout, L, Schaible, T, Cohen-Overbeek, TE, et al. Actual outcome in infants with congenital diaphragmatic hernia: the role of a standardized postnatal treatment protocol. Fetal Diagn Ther 2011;29(1):55–63.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×