Congenital Diaphragmatic Hernia
Treatment

Most babies with CDH are born with such small lungs that they can't breathe on their own. If this happens your baby will be moved to the Intensive Care Nursery, where a mechanical ventilator — a breathing machine — will help your baby receive enough oxygen. An extracorporeal membrane oxygenation (ECMO) machine, which temporarily does the work of breathing for your baby, may also be recommended. In ECMO, blood is drained from your baby into an artificial lung where oxygen is added and carbon dioxide is removed, then the blood is pumped back into your child.

For babies whose liver hasn't grown into the chest cavity, survival with treatment after birth is very good, about 90 percent. For these infants, we recommend that the baby be born in a hospital with an Intensive Care Nursery that has the capability to provide ECMO. ECMO treatment can be used only for a limited time, usually about two weeks.

In the most severe cases of CDH, where a portion of the liver has grown into the chest and ultrasounds reveal that the lungs are small, fetal treatment may be considered. To be considered for fetal surgery, fetuses must have a normal karyotype, a test that shows that the chromosomes are normal and there are no other defects. Only the most severely affected fetuses with a survival rate estimated at less than 50 percent are offered the option for fetal surgery.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated March 10, 2010