Congenital diaphragmatic hernia is a rare congenital anomaly of diaphragmatic development with a frequency of approximately 1 in 2,500 live births. The structural defect is accompanied by pathophysiological disorders, in particular, pulmonary hypertension, as well as pulmonary hypoplasia of various degrees, which actually determine the severity of the defect. In 84% of cases, the diaphragmatic hernia is located on the left dome of the diaphragm, possible right-sided and left-sided localization of the malformation, which is 14 and 2%, respectively.The defect can be either isolated or combined with other congenital anomalies, such as congenital heart disease or chromosomal abnormalities. Violation of the closure of the diaphragm during the 4-10th week of fetal development leads to the formation of the diaphragmatic grid. During the same period (5th week of gestation) is the formation of lungs and bronchs. Three-dimensional ultrasound diagnosis allows to detect prenatal defect in almost 60% of fetuses. Fetal MRI is a method of choosing the anatomical assessment of the lungs, determining their volume allows you to more accurately predict the development of complications and the required amount of care after birth. The article is devoted to the description of clinical observation of ENT with a description of the features of perinatal diagnosis and organization of postnatal care. The defect was diagnosed at 31 weeks, vaginal delivery occurred during full-term pregnancy. The complex of resuscitation measures, preoperative preparation, the course of the postoperative period is described. Timely prenatal diagnosis of EDC and its anatomical variant makes it possible to correctly develop the patient’s route, starting with the tactics of pregnancy, method of delivery, as well as to predict the algorithm of staff actions at birth and subsequent treatment of the newborn.
Three‐dimensional reconstruction of defects in congenital diaphragmatic hernia: a fetal MRI study
