Congenital diaphragmatic hernia: About 4 cases

Introduction:

Congenital diaphragmatic hernia (CDH) is a rare but severe condition that occurs in 1 in approximately 2400 live births with a survival rate of 66%.

Improvements in prenatal ultrasound have resulted in approximately 50% of these infants being diagnosed early in pregnancy, usually between Week 16 and Week 24 of gestation.

Objective

To list utrasonography signs identified when a CDH is suspected

To analyze the relevance of diagnosis with utrasonography and magnetic resonance imaging

Patients and methods:

A retrospective study of 5 cases reported in our service from January 2011 until December 2013.

Results:

The mean age was 32,6 years old

Case1: finding of the defect at 29weeks, ultrasonography: Hydramios, Right CDH:, MRI: Right CDH, absence of liver herniation, lung volume left: 40% to 50% of total pulomonary volume

Case2: 22weeks, utrasonography:left CDH

Case 3: 22weeks, utrasonography:Left CDH, intra uterine growth retardation, fetal caryotype: normal, MRI: left CDH, absence of liver herniation, lung volume left:30% of total pulmonary volume.

Case4: 24weeks, utrasonography: left CDH associated with cardiac defects (Hypoplastic left Heart, mitral dysplasia), fetal caryotype: normal

Surgical repair of CDH had taken place immediately after birth

Conclusion:

Many children with CDH develop pulmonary hypoplasia, a condition characterized by small, underdeveloped lungs that can affect not only breathing, but also heart function, ability to feed and overall development. It can be life-threatening unless treated. That's why prenatal diagnosis is important to determine the severity of fetus's condition.