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Article Dans Une Revue Prenatal Diagnosis Année : 2022

Antenatal management of congenital diaphragmatic hernia: What's next ?

Francesca Russo
  • Fonction : Auteur
Alexandra Benachi
  • Fonction : Auteur
Eduard Gratacos
  • Fonction : Auteur
Augusto Zani
  • Fonction : Auteur
Richard Keijzer
  • Fonction : Auteur
Emily Partridge
  • Fonction : Auteur
Nicolas Sananès
  • Fonction : Auteur
  • PersonId : 1087598
Paolo de Coppi
  • Fonction : Auteur
Michael Aertsen
  • Fonction : Auteur
Kypros H. Nicolaides
  • Fonction : Auteur
Jan Deprest
  • Fonction : Auteur

Résumé

Congenital diaphragmatic hernia can be diagnosed in the prenatal period and its severity can be measured by fetal imaging. There is now level I evidence that, in selected cases, Fetoscopic Endoluminal Tracheal Occlusion with a balloon increases survival to discharge from the neonatal unit as well as the risk for prematurity. Both effects are dependent on the time point of tracheal occlusion. Fetoscopic Endoluminal Tracheal Occlusion may also lead to iatrogenic death when the balloon cannot be timely retrieved. The implementation of the findings from our clinical studies, may also vary based on local conditions. These may be different in terms of available skill set, access to fetal therapy, as well as outcome based on local neonatal management. We encourage prior benchmarking of local outcomes with optimal postnatal management, based on large enough numbers and using identical criteria as in the recent trials. We propose to work further on prenatal prediction methods, and the improvement of fetal intervention. In this manuscript, we describe a research agenda from a fetal medicine perspective. This research should be in parallel with innovation in neonatal and pediatric (surgical) management of this condition.

Dates et versions

hal-03777637 , version 1 (14-09-2022)

Identifiants

Citer

Francesca Russo, Alexandra Benachi, Eduard Gratacos, Augusto Zani, Richard Keijzer, et al.. Antenatal management of congenital diaphragmatic hernia: What's next ?. Prenatal Diagnosis, 2022, 42 (3), pp.291-300. ⟨10.1002/pd.6120⟩. ⟨hal-03777637⟩
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