{"id":2245,"date":"2019-08-01T18:03:41","date_gmt":"2019-08-01T23:03:41","guid":{"rendered":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/?page_id=2245"},"modified":"2019-08-02T09:14:03","modified_gmt":"2019-08-02T14:14:03","slug":"cdh-overview","status":"publish","type":"page","link":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/home\/2019-projects\/frog-muscle\/disease-highlight-congenital-diaphragmatic-hernia\/cdh-overview\/","title":{"rendered":"CDH Overview"},"content":{"rendered":"

\"CDH<\/a>
CDH results from a hole formed in the hernia during development, potentially leading to migration of bowel contents into the chest cavity. Original image (User Theresa knott [CC BY-SA 2.5 (https:\/\/creativecommons.org\/licenses\/by-sa\/2.5)])<\/figcaption><\/figure>What is Congenital Diaphragmatic Hernia (CDH)?<\/strong><\/p>\n

To understand CDH is to first understand the diaphragm<\/a>. This skeletal muscle forms the boundary between the heart and lungs and the abdominal cavity<\/a>. Contraction of the diaphragm drives respiration. In CDH, a hole forms in the diaphragm during development. Depending on hole size (severity), this can sometimes allow contents of the abdominal cavity to migrate into the chest.<\/p>\n

With\u00a0abdominal contents in the chest, the lungs can become obstructed. This sometimes\u00a0results in pulmonary hypoplasia<\/a> (underdeveloped lungs), pulmonary hypertension<\/a>, developmental delays, and\u00a0additional health challenges\u00a0after birth. More severe forms of CDH can\u00a0be fatal. Hernial\u00a0defects\u00a0can occur anywhere within the diaphragm, but usually occur on the patient’s left side. It is unclear why this is the case.<\/p>\n

How is CDH diagnosed and managed?<\/strong><\/p>\n

Typically, CDH involves three major defects:\u00a0i) diaphragmatic defect,\u00a0<\/strong>resulting in failure to close,\u00a0ii) migration of abdominal contents\u00a0<\/strong>into the chest cavity,\u00a0<\/strong>and\u00a0iii) lung hypoplasia<\/strong>.<\/p>\n

Diagnosis of CDH can be\u00a0before or after birth of the baby. Sometimes, defects are quite apparent by ultrasound<\/a>. Milder cases\u00a0can require a skilled sonographer<\/a> to detect the hole (hernia), or a fetal MRI<\/a>. Typically, healthcare professionals\u00a0leery of CDH will\u00a0use these tools to\u00a0identify\u00a0underdeveloped lungs<\/strong>,\u00a0ectopic<\/a> location of organs<\/strong>\u00a0(such as bowels in the chest or displaced heart),\u00a0and\u00a0liver position<\/strong>\u00a0to aid in diagnoses (see below).<\/p>\n

\"Head,<\/a>
Head, right; feet, left; thorax (chest), center. In this ultrasound of CDH, the stomach and heart can both be seen within the thorax. (Dr Laughlin Dawes [CC BY 3.0 (https:\/\/creativecommons.org\/licenses\/by\/3.0)])<\/figcaption><\/figure>Depending on severity, CDH can be managed prenatally or postnatally, but often both. Prenatal\u00a0interventions most often involve\u00a0close monitoring, and some cases may require\u00a0surgery. Most of the time, babies with prenatally diagnosed CDH will undergo vaginal birth. For more severe cases, mother may be transferred to a hospital where\u00a0delivery can take place near a center with ample support.\u00a0This can include\u00a0E<\/strong><\/span>xtra<\/strong>c<\/span><\/strong>orporeal\u00a0<\/strong>M<\/span><\/strong>embrane\u00a0<\/strong>O<\/span><\/strong>xygenation (ECMO<\/a>),\u00a0<\/strong>wherein the heart and lungs are bypassed until the baby can breathe autonomously.<\/p>\n

Proper precautions and care for babies\u00a0born with\u00a0CDH\u00a0requires\u00a0a team of qualified healthcare professionals.<\/p>\n","protected":false},"excerpt":{"rendered":"

What is Congenital Diaphragmatic Hernia (CDH)? To understand CDH is to first understand the diaphragm. This skeletal muscle forms the boundary between the heart and lungs and the abdominal cavity. Contraction of the diaphragm drives respiration. In CDH, a hole forms in the diaphragm during development. Depending on hole size (severity), this can sometimes allow…<\/p>\n","protected":false},"author":8390,"featured_media":0,"parent":2042,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"tags":[],"class_list":["post-2245","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/pages\/2245","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/users\/8390"}],"replies":[{"embeddable":true,"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/comments?post=2245"}],"version-history":[{"count":4,"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/pages\/2245\/revisions"}],"predecessor-version":[{"id":2307,"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/pages\/2245\/revisions\/2307"}],"up":[{"embeddable":true,"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/pages\/2042"}],"wp:attachment":[{"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/media?parent=2245"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/my.vanderbilt.edu\/pdbbootcamp\/wp-json\/wp\/v2\/tags?post=2245"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}