Learning your unborn child has a congenital diaphragmatic hernia can be scary. But at the Colorado Fetal Care Center, we help ensure a healthy, safe delivery for you and your baby and work to obtain the best possible outcome for your family.
Diaphragmatic hernias are typically treated at and after birth. However, the most severe cases – if it's anticipated the lungs will be so underdeveloped the baby won’t be able to breathe after birth – may be treated before baby is born (prenatally).
FETO: prenatal treatment for CDH
The Colorado Fetal Care Center specializes in advanced fetal surgery techniques. For the most severe cases of CDH, our MFM specialists may recommend fetoscopic endoluminal balloon tracheal occlusion (FETO), a minimally invasive fetal surgery performed to accelerate fetal lung growth. FETO is considered an experimental fetal therapy and not every CDH patient is a candidate for this procedure. At Children's Colorado, we are one of only eight approved U.S. FETO trial sites in the country.
With FETO, the hope is that the lungs can grow enough that a baby will be able to breathe successfully once they're born and avoid open fetal or neonatal surgery. Learn more about FETO therapy for severe CDH.
ECMO and breathing support
For severe cases of CDH, post-birth care may include the use of extracorporeal membrane oxygenation (ECMO), a machine that performs the function of the heart and lungs while they are growing.
Level IV NICU
Our Neonatal Intensive Care Unit (NICU) has earned the highest distinction (Level IV) and is a nationally recognized leader in the treatment of critically ill infants. Our fully dedicated labor and delivery unit is just down the hall from our NICU so you can deliver here and stay with your baby while they are treated.
Your fetal care team will recommend the best method of delivery for you. Each case is different, and your specific treatment plan will be aimed at optimizing outcomes. In some severe cases of CDH, a caesarean section may be best.
Diaphragmatic hernia repair
Repair of your baby's CDH will be carefully orchestrated by our dedicated CDH team. When the time is right, our team will perform surgery to repair your child's diaphragm and allow their lungs to grow. Our experienced team of experts will make the right decision for your baby in coordination with you and your family.
Why choose Children's Colorado for CDH treatment?
The fetal care team at our Colorado Fetal Care Center is at the forefront of treatment for this condition. We have a dedicated labor and delivery unit for moms to deliver here, so their baby can be monitored and treated in our NICU for post-birth care just steps away from one another.
For severe cases of CDH, we provide the use of ECMO, which allows your baby's underdeveloped lungs to grow, as well as advanced treatments for pulmonary hypertension. We also continually participate in research so you and your baby has access to the newest, most advanced treatments possible.
Of patients delivered on-site in 2020
Patients with CDH treated
What are the complications of CDH?
A diaphragmatic hernia can cause several complications depending on the size and location of the opening. The two main problems include pulmonary hypoplasia and pulmonary hypertension.
Pulmonary hypoplasia in CDH patients
The most common CDH complication is pulmonary hypoplasia, or underdeveloped lungs. This condition results from the abdominal contents (bowel, stomach and liver) putting pressure on the fetal lungs, preventing them from growing normally. Pulmonary hypoplasia can lead to a variety of ailments after birth, including:
- Pulmonary hypertension (high blood pressure in the lungs)
- Respiratory failure
- Feeding problems
- Developmental delays
In some cases, the pulmonary hypoplasia can be significant enough to affect the survival of the newborn. That's why early detection and diagnosis of CDH are so important. By diagnosing CDH prenatally, our dedicated CDH team has time to design the optimal delivery and treatment plan for your baby. Our Pulmonary Hypoplasia Clinic is the only multidisciplinary clinic in the Rocky Mountain region offering comprehensive care for infants and children with conditions that limit lung growth.
Inhaled nitric oxide treatment for pulmonary hypertension
Pulmonary hypertension, or high blood pressure in the lungs, is a disorder that occurs when the blood vessels lining the lungs (pulmonary arterioles and capillaries) become narrowed, and the number of blood vessels in the lungs reduces. This makes it hard for blood to flow through the lungs, raising the heart’s blood pressure and making it work harder than usual. This can potentially lead to heart failure.
At Children's Colorado, we pioneered the use of inhaled nitric oxide to treat persistent pulmonary hypertension of the newborn (PPHN). This is now the international standard of care for PPHN. Our Pediatric Pulmonary Hypertension Program is one of three pediatric programs in the country accredited by the Pulmonary Hypertension Association for the ability to diagnose and care for medically complex patients.
Our fetal care team ensures that you will meet all our specialists in one meeting to map out your care plan. We care for your medical and emotional needs before, during and after your delivery and as your child grows.