What is a Congenital Diaphragmatic Hernia (CDH)?
A congenital diaphragmatic hernia is a birth defect where there is an opening in the muscle that helps you breathe, called the diaphragm. This opening can be on the right or left side, but is most common on the left.
The contents of the belly, including the stomach, spleen, liver and intestines go up into the chest. This can lead to little room for the lungs to grow and develop.
Incidence of CDH
Early in the pregnancy, many organs are forming at the same time. The tissue from the lungs and stomach area does not form correctly, leaving a hole in the diaphragm. Many factors might play a part, such as multiple genes and environment but there really are no known causes.
- CDH happens in about one in every 2,200 babies.
- About one in three babies with CDH will also have another birth defect. The most common problem is a heart defect.
- Between 5 percent to 16 percent may have a problem with their genes, such as Trisomy 21 (or Down syndrome).
- Having a parent or sibling with the condition slightly increases the risk.
- About 1 percent of babies with CDH are found during X-rays for other problems.
Signs and Symptoms of CDH
- Bluish colored skin due to lack of oxygen
- Fast breathing
- Fast heart rate
- Stomach looks like it is sunk in
- Difficulty breathing
- Noisy sounds with each breath
Congenital Diaphragmatic Hernia Treatment
Breathing support is needed before and after surgery. Sometimes, a heart / lung bypass machine is used to help the lungs heal. A baby with CDH needs surgery to put organs into the correct place and close the opening in the diaphragm.
Prenatal Management & Treatment
Congenital Diaphragmatic Hernia Prognosis
Babies born with CDH need regular follow-up with specialists after leaving the hospital.
Many babies have long-term breathing issues and may require oxygen and medications for weeks, months or years. They are at risk to develop colds and other illnesses.
They often need more calories to grow. A feeding tube might be necessary.
Some babies might not meet their developmental milestones and will need additional therapy services to help with muscle strength, feedings and activities of daily living.