Congenital Diaphragmatic Hernia
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A Congenital Diaphragmatic Hernia (CDH) is birth defect which stems from a hole in the diaphragm. The organs in the abdomen can herniate through this hole and hamper lung development resulting in high blood pressure in the lungs at birth and severe breathing problems. CDH impacts about 1 in 2,200 births. Typically CDH occurs during fetal development and can often be diagnosed by ultrasound or post-delivery if the baby presents breathing difficulties.
There are two kinds of diaphragmatic hernias:
- Bochdalek Hernia - This is the more common and severe type of CDH (80% or more) in which the hernia is usually on the left side of the diaphragm. The hole in the diaphragm will enable the stomach and intestines of the baby to spread into the thoracic cavity which impacts development and growth of the lungs.
- Morgagni Hernia - In this type of CDH, the opening is on the right side of the diaphragm, allowing the liver and intestines to fill the chest.
Ultrasounds at 16 to 18 weeks are critical in potentially diagnosing a CDH condition. Ultrasounds can determine the lung size of the fetus (via a lung-to-head ratio) and alert ultrasound technicians, obstetricians (doctors), nurses and other medical professionals if lung development is compromised. If problems are detected, then additional tests such as MRIs and fetal echocardiograms may be warranted.
Occasionally a severe abnormality may be treated prior to birth, but generally a diagnosis of CDH will mean that a medical team needs to be prepared at delivery to administer breathing assistance (ventilation) and carefully monitor the newborn. Once the baby's breathing is stabilized, most will undergo surgery to repair the diaphragmatic hernia. The success rate of such surgery is high, especially with persistent follow up care. Depending upon the severity there may be long term complications with the development and or capacity of the lungs. This may require additional treatment, medications or ventilation assistance.
CDH, like many other birth defects, can often be diagnosed by an ultrasound. It is critical that expectant mothers seek out pre-natal care. It is also important that medical providers diligently use ultrasound and other prenatal testing to find abnormalities so that they can be monitored or treated proactively. Not all cases of CDH can be found via an ultrasound; therefore, doctors must be responsive to signs of respiratory difficulties and abnormal rapid heart rates upon delivery. If CDH is not treated in a timely fashion, babies may suffer severe breathing problems that could be fatal.
If you believe that the birth of your child's health was compromised by a failure to properly diagnose a Congenital Diaphragmatic Hernia in Kentucky, you may want a Louisville medical malpractice lawyer that handles complex medical negligence cases in Kentucky to consider your case and answer your questions.