Congenital Diaphragmatic Hernia (CDH)

Congenital Diaphragmatic Hernia (CDH) is a serious birth abnormality that affects about 1 of every 2,500 newborn babies every year, where the abdominal organs move into the chest, hindering lung development. Early diagnosis and timely surgical intervention can significantly improve survival and long-term outcomes. In case your baby is diagnosed with CDH, it is important to understand the condition, the treatment options available, and the recovery journey ahead.

Diaphragmatic hernia is a condition that results from a lack of full development of the diaphragm. It is the muscular tissue that separates the abdomen and the chest, and this normally happens in the very early pregnancy of about six to eight weeks. This leaves a hole in most cases on the left side, which is medically referred to as a Bochdalek hernia. Through this opening, organs such as the intestines, liver, or stomach may shift into the chest cavity, crowding the lungs and affecting their development. Even though this is not evident what brings it, there are a couple of factors that can cause it. 

Congenital diaphragmatic hernia is a rare disease that takes place in 1 in every 2,500 births and occurs more frequently in boys. Early diagnosis and guidance from an experienced, competent paediatric surgeon are important to determine the best course of care.

A diaphragmatic hernia can often be diagnosed by:

• A routine ultrasound scan during pregnancy. 
• A chest x-ray that shows which organs are in the chest area and how much they are squashing the lungs. 
• Blood tests to show how much oxygen is contained in the blood are also commonly used.

After birth, the baby is admitted to the hospital and placed in an incubator.

• A naso-gastric tube is inserted to reduce stomach pressure.
• Fluids and medication are given through an IV drip.
• Breathing support is provided using a ventilator or oscillator.
• If ventilation is difficult, ECMO support may be used.
• Surgery is only done once the baby is stable.

The congenital diaphragmatic hernia surgeon in Dubai explains the procedure, and consent is taken from the family.

During the operation, the surgeon moves the child’s intestines from the chest back into the abdominal cavity and repairs the hole in the diaphragm. If the defect is large, a synthetic patch may be used to close it. Twisting of the intestines, which can occur when they shift into the chest, is corrected during the same procedure. In cases where part of the bowel is damaged due to compression, it may be removed. This surgical procedure is a critical component of congenital diaphragmatic hernia treatment in Dubai.

After congenital diaphragmatic hernia surgery in Dubai, the baby returns to the ward for close monitoring. They will remain on a ventilator for a period, depending on lung development, and be connected to monitors tracking vital signs. Pain relief is given through an IV, and a chest drain may be placed temporarily. Feeding typically begins with intravenous nutrition (TPN) until the intestines recover, followed by the gradual introduction of milk via a naso-gastric tube. As the baby improves, ventilators and monitors are removed step by step. Once feeding is established and weight gain is steady, transfer to a general ward is arranged.