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Treating Congenital Diaphragmatic Hernia in new-borns

Treating Congenital Diaphragmatic Hernia in new-borns- NWoBS blog


Treating Congenital Diaphragmatic Hernia in new-borns


Overview of the concept of CDH

The congenital diaphragmatic hernia (CDH) talks about a condition that is characterized by a weakness in the diaphragm leading to protrusion of the contents in the abdomen into the thoracic cavity with the interference of the normal development of the lungs. This defect ranges from a small aperture in the posterior rim of the muscle that needs to be completed in the absence of the diaphragm.

The path physiology of CDH is actually a combination of lung hypoplasia along with immaturity that is associated with persistent hypertension in the pulmonary of the new-born along with cardiac dysfunction. The prenatal assessment of the lung with the head ratio in comparison with the liver position with the help of ultrasound that is used for diagnosing and predicting the outcomes. The delivery of the infants having CDH is recommended close to the term gestation.

What causes a new-born to get affected by congenital diaphragmatic hernia?

A diaphragmatic hernia refers to a congenital disability or an abnormality occurring before the birth that develops in the foetus form in the mother's uterus. It generally occurs when the diaphragm is not able to form in a proper manner.

Symptoms of Congenital Diaphragmatic Hernia

The degree of severity of the symptoms depends on its size, cause and the organs involved. The basic symptoms include:

•    Breathing difficulties

•    Rapid heartbeats

•    Blue discoloration of the skin

•    Absent breath sounds

•    Bowel sounds in the chest area

•    Lesser full abdomen

Diagnosis of the congenital diaphragmatic hernia

The best paediatric surgeon in Delhi can help you with the diagnosis of congenital diaphragmatic hernia before the baby is born. Majority of the cases are revealed at the time of birth during the ultrasound sessions of the foetus. This may include cases of increase in the amniotic fluid within the uterus area of the mother. Soon after the birth, several abnormalities may appear when a physical examination is done.

Several tests are done to diagnose such cases. The tests done by the best paediatric surgeon in Delhi for treating congenital diaphragmatic hernia include:

X-rays

Ultrasound Scanning that uses sound waves and produces images of the thoracic and abdominal cavities with their contents

CT Scans that allows a direct view of the abdominal organs

Arterial Blood Gas test that takes blood supply directly from an artery and tests the levels of oxygen, carbon dioxide, acidity, and pH levels

MRI for a proper organ evaluation for the foetus

The immediate management during the time of birth includes decompression of the bowel, avoidance of mask ventilation along with endotracheal tube placement as per the requirement. The management mainly focuses on the inclusion of gentle ventilation, monitoring the hemodynamic along with the treatment of pulmonary hypertension that is at the end followed by the surgery. Inhaled Nitric Oxide is used for treating congenital diaphragmatic hernia even though it is not approved by the FDA.

These types of cases are very serious in nature. The proper diagnosis helps to curb out all the issues and cure the child.

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