Congenital diaphragmatic hernia (CDH)

Sun, 29 Apr 2012 13:50:49 GMT

This video clip demonstrates left sided congenital diaphragmatic hernia (CDH) and intrathoracic stomach in the fetus with increased nuchal translucency (NT) thickness at 12 weeks' gestation.

The birth prevalence of diaphragmatic hernia is about 1 per 4,000 and the condition is usually sporadic. The prevalence of chromosomal defects, mainly trisomy 18, is about 20%.

In the case presented the fetus had multiple anomalies: CDH, brain abnormality, congenital heart defect (tetralogy of Fallot), echogenic kidneys with pyeloectasis and generalised edema.

Increased NT thickness is present in about 40% of fetuses with diaphragmatic hernia, including more than 80% of those that result in neonatal death due to pulmonary hypoplasia and in about 20% of the survivors (Sebire et al 1997). It is possible that in fetuses with diaphragmatic hernia and increased NT the intrathoracic herniation of the abdominal viscera occurs in the first trimester and prolonged compression of the lungs causes pulmonary hypoplasia. In the cases where diaphragmatic hernia is associated with a good prognosis, the intrathoracic herniation of viscera may be delayed until the second or third trimesters of pregnancy.

Ultrasound Link - congenital diaphragmatic hernia

Congenital diaphragmatic hernia (CDH)