Knowledge Gaps in the Fetal to Neonatal Transition of Infants With a Congenital Diaphragmatic Hernia

Philip L.J. DeKoninck*, Emily J.J. Horn-Oudshoorn, Ronny Knol, Kelly J. Crossley, Irwin K.M. Reiss

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

2 Citations (Scopus)
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Clinical research for infants born with a congenital diaphragmatic hernia (CDH) has until recently mainly focused on advances in prenatal and postnatal treatment. However, during the early perinatal transition period there are major physiological adaptations. For most infants these changes will happen uneventfully, but for CDH infants this marks the beginning of serious respiratory complications. In recent years, there is emerging evidence that the clinical management during the perinatal stabilization period in the delivery room may influence postnatal outcomes. Herein, we discuss major knowledge gaps and novel concepts that aim to optimize fetal to neonatal transition for infants with CDH. One such novel and interesting approach is performing resuscitation with an intact umbilical cord, the efficacy of this procedure is currently being investigated in several clinical trials. Furthermore, close evaluation of neonatal physiological parameters in the first 24 h of life might provide early clues concerning the severity of lung hypoplasia and the risk of adverse outcomes. We will provide an overview of trending concepts and discuss potential areas for future research.

Original languageEnglish
Article number784810
JournalFrontiers in Pediatrics
Publication statusPublished - 14 Dec 2021

Bibliographical note

Funding Information:
PD and EH-O were supported by a grant from Sophia Children’s Hospital Foundation (SSWO, Grant S19-12). This research was supported by the National Health and Medical Research Council (NHMRC) Project Grant APP1187580 (KC and PD).

Publisher Copyright:
Copyright © 2021 DeKoninck, Horn-Oudshoorn, Knol, Crossley and Reiss.


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