Blue Babies Fast Facts – (CDH) Congenital Diaphragmatic Hernia

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CDH affects 1 in 3 000 babies and is a serious, life-threatening condition.

  • Congenital Diaphragmatic Hernia (CDH) is a defect in the diaphragm that results in the abdominal organs (intestines, liver, stomach and spleen) moving up through the hole into the chest cavity. The normal development of the lungs is impeded.
  • It can be diagnosed during a routine antenatal ultrasound, but can also be diagnosed soon after birth when certain symptoms present including cyanosis (bluish colour to the skin due to lack of oxygen), breathing problems, elevated heart rate, collapsed abdomen and one side of the chest having no air entry.
  • Antenatal diagnosis contributes to better management. For example, the site/timing of delivery. If it only presents at birth, urgent assessment and resuscitation by a neonatologist is imperative.
  • CDH is not regarded as a paediatric surgical emergency – the surgical removal of the contents from the chest back into the abdomen with repair of the diaphragmatic defect is only indicated once the baby is stabilised.
  • The ultimate prognosis depends on the amount of functional lung tissue that the child is born with and the associated abnormalities – it’s not influenced by surgical repair.
  • Highly specialised neonatal intensive care with cardiorespiratory support is not only vital but life
    saving during the first few days,
    with a survival rate of 50 to 60%.
  • Normal long-term development is dependent on the care in ICU, and advances in neonatal intensive care have contributed largely to the improving survival rate.

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