CDH occurs when there is an opening in the diaphragm, the muscle that separates the organs in the abdomen from the organs in the chest. The abnormal development of the diaphragm, occurring before birth, causes a hole in this muscle that helps control breathing and is linked to the development of the lungs. CDH may range from a small hole, or hernia, to the complete lack of the diaphragm.
As a result of an absent or partially formed fetal diaphragm, the abdominal organs (stomach, intestines, liver, spleen, kidneys) move into the chest opening during pregnancy and crowd the baby’s heart and lungs. This can lead to compression and underdevelopment of the lungs (pulmonary hypoplasia), and potentially life-threatening breathing difficulties after birth. While most infants with CDH improve following surgery, some may have challenges with other organs (brain, intestines, etc) and some children need additional surgery (feeding tube, bowel blockage, hernia recurrence, etc). Fortunately, these challenges and complications are almost always repairable. Moreover, almost every affected system is inside the body – the child’s face and external body are typically normal.
Children’s Memorial Hermann Hospital and affiliated physicians provide families with a continuum of care and resources for their child’s healthcare needs from fetal diagnosis, through infancy, childhood and into adulthood.