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Navigating Congenital Diaphragmatic Hernia in Twins
A hole in the diaphragm, the flimsy muscular sheet that separates the chest from the abdomen, results in a congenital diaphragmatic hernia (CDH). The colon, stomach, or even the liver may travel into the chest cavity when this opening develops during a fetus’s growth in the womb.
These abdominal organs’ presence in the chest reduces the amount of room for the lungs and may cause respiratory issues. As a result of CDH’s requirement that the lungs expand when compressed, several parts of their functionality could not become fully mature until after the baby is born.
A significant congenital anomaly called CDH, which affects 1 in every 2,500 to 3,000 live births, is one of the most frequent ones. Left or right side CDH is possible, as well as seldom both sides. Early and precise diagnosis is crucial because newborns with CDH will need emergency care upon delivery.
The Causes Of CDH
There is no known cause of CDH. Although it can arise in conjunction with cardiac disease or a genetic anomaly that can cause extra difficulties, CDH is typically an isolated finding.
Medical institutes are actively conducting studies to learn more about the relationships and root causes of CDH. Innovative methods are being used by genetic experts to look for a possible genetic cause of CDH. The doctors will be better able to support and manage families with a child who has CDH if the hereditary cause(s) of the condition have been identified.
What Are The Signs & Symptoms Of CDH?
Usually, CDH is identified during a regular prenatal ultrasound. The stomach, intestine, or liver may be visible in the baby’s chest where the lungs ought to be, according to the sonographer. The extra organs in the chest may also shift the baby’s heart to one side.
Evaluation & Diagnosis
CThe location of the liver is the best indicator of CDH severity. More pulmonary hypoplasia occurs when the liver is positioned higher in the chest (small lungs). Measurements taken during fetal ultrasonography and MRI can be used to predict the severity of pulmonary hypoplasia. The below-mentioned calculations estimate the volume (size) of the developing lungs:
The ratio of head circumference to the lung area
Lung area to head circumference observed versus predicted
Total lung capacity compared to what was anticipated by MRI
Yet, they are unable to foretell the severity of pulmonary hypertension, which has an impact on how well the lungs will function once the baby is born.
Left CDH vs Right CDH
A deformity on the left side of the diaphragm is seen in about 83% of infants with CDH. The likelihood of the stomach, intestines, and occasionally the liver moving (herniating) up into the baby’s chest is made possible by a left-sided CDH.
The right side of the diaphragm is defective in the remaining 17% of infants with CDH. The liver can virtually always enter the chest with a right-sided CDH.
Visit a fetal treatment facility with a multidisciplinary staff with experience examining pregnancies impacted by CDH to obtain an accurate diagnosis. This is a crucial step in choosing the best course of therapy for your child and ensuring the best results.
Successful Treatment Of Congenital Diaphragmatic Hernia In A Newborn Twin At Parul Sevashram Hospital
The doctors at PSH performed a critical congenital diaphragmatic hernia surgery to save a newborn baby. This was a rare case taken up by Parul Sevashram Hospital. It was only the 7th case in the world.
One in every 2500–3000 live newborns has a serious congenital anomaly called CDH, which is one of the more prevalent ones.
Only six twins born with CDH have survived around the world, according to data that has been recorded thus far, according to paediatric surgeon Dr Mishal Patel.
The last instance of twins with CDH was reported in Turkey in 2012. An elderly lady in her 40s who delivered twins with antenatally diagnosed CDH sent us to this case from a little hospital in Godhra, the man stated.
When they were born, one baby weighed 1.6 kg and the other 1.2 kg.
Both underwent primary diaphragmatic repair on the second day.
Both infants underwent successful postoperative NICU stays.
On the fifth surgical day, both patients were thankfully taken off the ventilator, Dr Patel continued.
One of the twins passed away on the tenth postoperative day. However, the lighter baby survived and eventually got discharged on the 32nd day.
He stated that the infant was now two months old, weighed two kilogrammes, and was doing well at home.
According to Dr Geetika Madan Patel, the medical director at Parul Sevashram Facility, “doctors at our hospital performed such important surgery making it the sixth reported instance in the globe.”
Undoubtedly, with their commendable knowledge, skills & expertise,Parul Sevashram’s doctors have come a long way in the journey of providing better healthcare to the people of India.
A big thanks and thumbs up to the whole team of NICU at PSH for their competence and commitment!
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