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

Russo, Francesca; Benachi, Alexandra; Gratacos, Eduard; Zani, Augusto; Keijzer, Richard; Partridge, Emily; Sananes, Nicolas; ... Deprest, Jan; + view all (2022) Antenatal management of congenital diaphragmatic hernia: What's next ? Prenatal Diagnosis , 42 (3) pp. 291-300. 10.1002/pd.6120. Green open access

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Abstract

Congenital diaphragmatic hernia (CDH) 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 (FETO) 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. FETO may also lead to iatrogenic death when done in unexperienced centres. 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. This article is protected by copyright. All rights reserved.

Type: Article
Title: Antenatal management of congenital diaphragmatic hernia: What's next ?
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pd.6120
Publisher version: https://doi.org/10.1002/pd.6120
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Congenital diaphragmatic hernia, extracellular vesicles, fetoscopic endoluminal tracheal occlusion, pulmonary hypoplasia, treprostinil
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10144534
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