scholarly journals The TOTAL trial dilemma: A survey among professionals on equipoise regarding fetal therapy for severe congenital diaphragmatic hernia

2020 ◽  
Author(s):  
Simen Vergote ◽  
Daniel Pizzolato ◽  
Francesca Russo ◽  
Kris Dierickx ◽  
Jan Deprest ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Fetal Therapy ◽  
Total Trial

scholarly journals VP20.03: The TOTAL trial dilemma: a survey among professionals on equipoise regarding fetal therapy for severe congenital diaphragmatic hernia

2020 ◽  
Vol 56 (S1) ◽  
pp. 138-138
Author(s):  
S. Vergote ◽  
D. Pizzolato ◽  
F. Russo ◽  
K. Dierickx ◽  
J. Deprest ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Fetal Therapy ◽  
Total Trial

scholarly journals OP18.05: Evaluating variability in antenatal sonographic prognostication of congenital diaphragmatic hernia across the North American Fetal Therapy Network

2018 ◽  
Vol 52 ◽  
pp. 120-120
Author(s):  
N. Abbasi ◽  
G. Ryan ◽  
M. Sanz Cortes ◽  
R. Ruano ◽  
A. Johnson
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
North American ◽  
Fetal Therapy ◽  
The North

Prenatal assessment of congenital diaphragmatic hernia at north american fetal therapy network centers: A continued plea for standardization

2020 ◽  
Author(s):  
Erin E. Perrone ◽  
Nimrah Abbasi ◽  
Magdalena Sanz Cortes ◽  
Uzma Umar ◽  
Greg Ryan ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
North American ◽  
Fetal Therapy

Neonatal and fetal therapy of congenital diaphragmatic hernia-related pulmonary hypertension

2021 ◽  
pp. fetalneonatal-2021-322617
Author(s):  
Felix R De Bie ◽  
Catherine M Avitabile ◽  
Luc Joyeux ◽  
Holly L Hedrick ◽  
Francesca M Russo ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Future Research ◽  
Fetal Therapy ◽  
Mortality And Morbidity ◽  
Pulmonary Vasodilation ◽  
Experimental Drug ◽  
Therapeutic Mechanisms ◽  
Experimental Treatments

Congenital diaphragmatic hernia (CDH) is a complex malformation characterised by a triad of pulmonary hypoplasia, pulmonary hypertension (PH) and cardiac ventricular dysfunction. Much of the mortality and morbidity in CDH is largely accounted for by PH, especially when persistent beyond the neonatal period and refractory to available treatment. Gentle ventilation, haemodynamic optimisation and pulmonary vasodilation constitute the foundations of neonatal treatment of CDH-related PH (CDH-PH). Moreover, early prenatal diagnosis, the ability to assess severity and the developmental nature of the condition generate the perfect rationale for fetal therapy. Shortcomings of currently available clinical therapies in combination with increased understanding of CDH pathophysiology have spurred experimental drug trials, exploring new therapeutic mechanisms to tackle CDH-PH. We herein discuss clinically available neonatal and fetal therapies specifically targeting CDH-PH and review the most promising experimental treatments and future research avenues.

Prediction of outcome in isolated congenital diaphragmatic hernia and its consequences for fetal therapy

2008 ◽  
Vol 22 (1) ◽  
pp. 123-138 ◽  
Author(s):  
Leonardo Gucciardo ◽  
Jan Deprest ◽  
Elise Done' ◽  
Tim Van Mieghem ◽  
Marc Van de Velde ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Fetal Therapy ◽  
Prediction Of Outcome

scholarly journals Overview of Fetal Therapy

2016 ◽  
Vol 10 (4) ◽  
pp. 387-392
Author(s):  
Tuangsit Wataganara
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Technological Development ◽  
Standard Of Care ◽  
In Utero ◽  
Fetal Therapy ◽  
The Usa ◽  
Potential Benefits ◽  
Prenatal Intervention ◽  
The Right

ABSTRACT An improving ability to diagnose fetal conditions with higher accuracy prompts an attempt for a salvage treatment in utero. Fetal conditions amendable for prenatal intervention are limited to only diseases that can either kill the baby in utero or leave the baby with significant handicap. Therapeutic intervention has to be highly selective. Factors that need to be considered before offering in utero treatment include the highly investigative nature of certain procedures. For instance, at the time of writing this paper, fetal endoluminal tracheal occlusion for severe congenital diaphragmatic hernia is still under a randomized controlled investigational trial to validate its potential benefits and risks to the fetus with severe congenital diaphragmatic hernia with suboptimal growth of the residual lung tissue. There are chances of procedure-related miscarriages, preterm premature rupture of the membranes, and maternal morbidity that need to be discussed in an unbiased counseling session. The right balance between potential benefits and harms requires validation with rigid scientific methodology before the practice has become a “standard of care.” For example, laser photocoagulation of anastomosing chorionic vessels has become a standard of care in many places due to its superior perinatal survival and composite outcomes, particularly for the childhood neurodevelopmental status. With an ongoing technological development, it is foreseeable that there will be more proposals of implementing novel medical technologies to the use of fetal therapy. Currently, there are only a handful of fetal care centers, and most of the experienced ones are clustered in developed part of Europe and the USA. Dissemination of this type of service which requires years of experiences to develop surgical skill and the support by the most technological advanced instrument and setting is a real challenge that need to be addressed, discussed, and solved as a global agenda. How to cite this article Wataganara T, Phithakwatchara N, Nawapun K. Overview of Fetal Therapy. Donald School J Ultrasound Obstet Gynecol 2016;10(4):387-392.

Prenatal management of the fetus with isolated congenital diaphragmatic hernia in the era of the TOTAL trial

2014 ◽  
Vol 19 (6) ◽  
pp. 338-348 ◽  
Author(s):  
Jan Deprest ◽  
Paul Brady ◽  
Kypros Nicolaides ◽  
Alexandra Benachi ◽  
Christoph Berg ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Prenatal Management ◽  
Total Trial

Results of Fetal Endoscopic Tracheal Occlusion for congenital diaphragmatic hernia and the set up of the randomized controlled TOTAL trial

2011 ◽  
Vol 87 (9) ◽  
pp. 619-624 ◽  
Author(s):  
Philip DeKoninck ◽  
Eduardo Gratacos ◽  
Tim Van Mieghem ◽  
Jute Richter ◽  
Paul Lewi ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Tracheal Occlusion ◽  
Randomized Controlled ◽  
Set Up ◽  
Total Trial
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