Prenatal treatment of severe congenital diaphragmatic hernia: there is still medical equipoise

2020 ◽  
Vol 56 (4) ◽  
pp. 493-497 ◽  
Author(s):  
J. Deprest
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Prenatal Treatment

Prenatal treatment with retinoic acid promotes pulmonary alveologenesis in the nitrofen model of congenital diaphragmatic hernia

2008 ◽  
Vol 43 (3) ◽  
pp. 500-507 ◽  
Author(s):  
Sandra Montedonico ◽  
Kaoru Sugimoto ◽  
Patrick Felle ◽  
John Bannigan ◽  
Prem Puri
Keyword(s):  
Retinoic Acid ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Prenatal Treatment

scholarly journals Prenatal treatment with rosiglitazone attenuates vascular remodeling and pulmonary monocyte influx in experimental congenital diaphragmatic hernia

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0206975 ◽  
Author(s):  
Jan-Hendrik Gosemann ◽  
Florian Friedmacher ◽  
Alejandro Hofmann ◽  
Julia Zimmer ◽  
Joachim F. Kuebler ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Vascular Remodeling ◽  
Prenatal Treatment

scholarly journals Clinically relevant timing of antenatal sildenafil treatment reduces pulmonary vascular remodeling in congenital diaphragmatic hernia

2016 ◽  
Vol 311 (4) ◽  
pp. L734-L742 ◽  
Author(s):  
Daphne S. Mous ◽  
Heleen M. Kool ◽  
Marjon J. Buscop-van Kempen ◽  
Anton H. Koning ◽  
Oleh Dzyubachyk ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Vascular Remodeling ◽  
Vascular Development ◽  
Vascular Diseases ◽  
Pulmonary Vasculature ◽  
Prenatal Treatment ◽  
Vasodilator Therapy ◽  
Volume Measurements ◽  
Pulmonary Vascular Development

Patients with congenital diaphragmatic hernia (CDH) suffer from severe pulmonary hypertension attributable to altered development of the pulmonary vasculature, which is often resistant to vasodilator therapy. Present treatment starts postnatally even though significant differences in the pulmonary vasculature are already present early during pregnancy. We examined the effects of prenatal treatment with the phosphodiesterase-5 inhibitor sildenafil on pulmonary vascular development in experimental CDH starting at a clinically relevant time. The well-established, nitrofen-induced CDH rodent model was treated daily with 100 mg/kg sildenafil from day 17.5 until day 20.5 of gestation (E17.5–20.5). Importantly, this timing perfectly corresponds to the developmental stage of the lung at 20 wk of human gestation, when CDH is detectable by 2D-ultrasonography and/or MRI. At E21.5 pups were delivered by caesarean section and euthanized by lethal injection of pentobarbital. The lungs were isolated and subsequently analyzed using immunostaining, real-time PCR, and volume measurements. Prenatal treatment with sildenafil improved lung morphology and attenuated vascular remodeling with reduced muscularization of the smaller vessels. Pulmonary vascular volume was not affected by sildenafil treatment. We show that prenatal treatment with sildenafil within a clinically relevant period improves pulmonary vascular development in an experimental CDH model. This may have important implications for the management of this disease and related pulmonary vascular diseases in human.

Right-Sided Congenital Diaphragmatic Hernia and Agenesis of the Lung - Diagnostic Pitfalls

2002 ◽  
Vol 41 (5) ◽  
pp. 441-447
Author(s):  
Tröbs R.-B. ◽  
Wild L. ◽  
Klöppel R. ◽  
Bennek J.
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Diagnostic Pitfalls
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