(Hernia—Diaphragmatic; Congenital Hernia of the Diaphragm)
Diaphragmatic hernia is a hole in the diaphragm that is present at birth. The diaphragm is the muscle between the chest and abdomen. Organs in the abdomen move through the hernia to the chest. They can push up against the lungs.
This hernia happens when the diaphragm does not form in the fetus as it should. It is not clear why this happens. It may be due to genes or the environment.
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Things that may raise the risk of a diaphragmatic hernia are:
- Obesity during pregnancy
- Smoking or drinking during pregnancy
- Low intake of vitamin A just before or during pregnancy
Symptoms may appear after birth or happen later. A baby with a diaphragmatic hernia may have:
- Problems breathing, such as fast breathing or grunting
- A blue tint to skin from lack of oxygen
- One side of the chest that looks larger than the other
- A belly that looks caved in
- Feeding problems
A diaphragmatic hernia is sometimes found before birth with an ultrasound.
For others, the doctor will ask about symptoms and health history. A physical exam will be done. Images of the chest will be needed. This can be done with a chest x-ray.
Treatment depends on how severe the hernia is. Emergency care may be needed after the baby is born. It may include closely watching the baby and helping with breathing and blood flow.
Surgery will be needed when the baby is well enough. It will move the organs back into place and repair the hole.
There are no known guidelines to prevent this problem.
- Bent, D., Nelson, J., et. al. Population-based validation of a clinical prediction model for congenital diaphragmatic hernias. J Pediatr, 2018; 201: 160–165.
- Congenital diaphragmatic hernia (CDH). Cincinnati Children's website. Available at: https://www.cincinnatichildrens.org/health/c/diaphragmatic-hernias.
- Congenital diaphragmatic hernia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/congenital-diaphragmatic-hernia.
- Congenital diaphragmatic hernia (CDH). UCSF Benioff Children's Hospital Fetal Treatment Center website. Available at: http://fetus.ucsf.edu/cdh.
- Marcin Chwistek, MD
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