Congenital diaphragmatic hernia (CDH)
Find a fetal care specialistWith congenital diaphragmatic hernia (CDH), organs in your baby’s belly can get pushed up to their chest, affecting their lung development and ability to breathe at birth. At our Center for Fetal Care, our fetal surgeons offer minimally invasive procedures to treat CDH while your baby is in the womb to help their lungs develop properly before birth. Our neonatal and pediatric surgery teams have specialized expertise in providing care for babies with CDH at delivery and after birth.
Learn more about what to expect when you come to us for your baby’s care.
What is congenital diaphragmatic hernia (CDH)?
Congenital diaphragmatic hernia occurs when a baby is born with an opening in the muscle wall separating the chest and abdomen (belly). This hole in the diaphragm develops early in a pregnancy as a baby grows in the womb.
Organs such as the intestines, stomach and liver can push through the hole into the chest cavity, crowding the lungs during development. Initially, that’s not a problem, as the placenta provides oxygen. But without enough space for the lungs to grow properly, babies can have difficulty breathing after birth.
What causes congenital diaphragmatic hernia?
The causes of CDH aren’t fully understood. Research shows that some cases are related to mutations (changes) in one or more genes.
Congenital diaphragmatic hernia symptoms and signs
The effects of CDH often show up on routine ultrasounds for prenatal care. These signs include:
- Excess amniotic fluid (liquid surrounding the baby in the protective membrane)
- Presence of abdominal organs in the chest
- Compression and impact on developing lung tissue
- Shifting of the heart in the chest
Congenital diaphragmatic hernia diagnosis
To confirm a CDH diagnosis before birth, your doctor orders additional imaging. The scans show lung size and how much the other organs are compressing them, helping us determine the next steps. We take these measurements using imaging such as:
- High-resolution fetal ultrasound
- Ultrafast fetal MRI
We also refer you to our genetics program for a consultation and evaluation. Learn more about the diagnostic imaging we use to diagnose fetal conditions.
Congenital diaphragmatic hernia treatment
We make treatment recommendations based on your baby’s lung development and help you choose the best option. To optimize your baby’s lung function and survival after delivery, our fetal surgeons may recommend minimally invasive fetal surgery.
Before birth, your baby’s lungs produce fluid that exits through the mouth. Blocking this flow keeps the fluid inside the lungs, helping them expand and grow so they can eventually provide enough oxygen.
Our fetal surgeons accomplish this goal with a procedure called fetoscopic endotracheal occlusion (FETO). They use a thin scope (flexible tube with a camera and light) inserted through a small belly incision. Using ultrasound guidance, they place a tiny balloon in your baby’s windpipe, temporarily blocking the fluid’s escape.
Surgeons remove the balloon several weeks later before delivery, when your baby’s lungs have developed more.
After surgery, our pediatric specialists provide ongoing care to manage any breathing problems. Our team includes providers from a range of medical fields, including pulmonology, cardiology, developmental pediatrics, nutrition and social work. We provide treatment and services to help you and your baby, and we partner with your baby’s pediatrician for routine care.
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