• Congenital Diaphragmatic Hernia / CDH Overview

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    Congenital Diaphragmatic Hernia / CDH is a defect in the diaphragm of the fetus. The diaphragm is the muscle and tissue that separates the chest and abdominal cavities.

    In Congenital Diaphragmatic Hernia / CDH, abdominal organs push into the chest cavity through the defect (or herniate), compressing the developing lungs. This results in severe pulmonary hypoplasia (arrested development of the lungs), causing the lungs to remain small and underdeveloped.

    The Cincinnati Fetal Center has performed more than 179 patient evaluations for fetal CDH since 2004. Patients are cared for by a dedicated CDH team consisting of neonatologists, pediatric surgeons, pediatric cardiologists, nurses, nutritionists and therapists.

    The cause of Congenital Diaphragmatic Hernia / CDH is thought to be failure of the diaphragm to develop at nine to 10 weeks of gestation. When closure does not occur, the intestinal organs may herniate into the chest cavity through the defect in the diaphragm. What causes the failure of the diaphragm to close is unknown.

    The incidence of Congenital Diaphragmatic Hernia / CDH is estimated at one in 2,200 births. Survival rate depends, in large part, on the delivery at or the immediate transfer to a tertiary-care hospital where the newborn can be treated promptly by a staff skilled in Congenital Diaphragmatic Hernia / CDH care.

    An ultrasound can detect characteristics of Congenital Diaphragmatic Hernia / CDH. Physicians, performing ultrasound, closely examine the entire chest and abdominal area to look for what can be very subtle signs of Congenital Diaphragmatic Hernia / CDH. This diagnosis can also be aided by fetal MRI.

    The Cincinnati Fetal Center has performed more than 179 prenatal evaluations for CDH since 2004. An average of 20 newborns with CDH is cared for each year in the Cincinnati Children’s NICU.

    CDH Survival Rates to Discharge (1/1/05-9/30/13)

    CDH Type Survival Rate
    Low-risk left CDH 93%
    Defined as: prenatally diagnosed singleton with LHR > 1 with minor or no other congenital anomaly or postnatally diagnosed isolated CDH 
    Severe CDH 40%
    Defined as: Observed:Expected LHR < 25% 
    Severe CDH     

    42%

    Defined as: PPLV < 15%, TLV < 18mL, LHR < 1 and liver up*

    * PPLV = percent predicted lung volume; TLV = total lung volume; LHR = lung-to-head ratio

  • Congenital diaphragmatic hernia (CDH) in infants.

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  • Patient Story

    cdh-robbie
    Robby Dumford was born with DCH. His care began before birth. Read his story.
  • Contact Us

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    If you would like to request an appointment or get more information about the Cincinnati Fetal Center, call us at 1-888-338-2559 (1-888-FETAL59).