Congenital Diaphragmatic Hernia

A congenital diaphragmatic hernia (CDH) is a life-threatening abnormality that occurs before birth as the fetus is forming in the mother's uterus. For reasons that are unclear, the muscle in babies with CDH does not form completely. An opening is present in the diaphragm (the muscle that separates the chest cavity from the abdominal cavity). This abnormality is most commonly seen on the left side of the body but may also occur on the right side or the central portion of the diaphragm. Some of the organs that are normally found in the abdomen, including some of the intestines, move up into the chest cavity through this opening. Since the intestines are in the chest cavity and not where they were supposed to be, the lungs cannot grow and develop normally and are smaller than they should be. The intestines can also push on the other lung and keep it from growing fully and can sometimes keep the heart from growing normally.

Many times, the lungs of babies with CDH are so small that they have a hard time breathing after they are born and need to be placed on a mechanical ventilator. Some babies need to be placed on temporary heart/lung bypass (called ECMO--extracorporeal membrane life support) if they have severe respiratory problems. Once the baby is stable, surgery is performed to repair the diaphragm and the stomach, intestine, and other abdominal organs are moved from the chest cavity back into the abdominal cavity. Some infants will require another operation to help with feeding or any other problems that might arise.