Long term respiratory outcomes of congenital diaphragmatic hernia, esophageal atresia, and cardiovascular anomalies
Introduction
Lung development is a lengthy process, starting during fetal life, and continuing in the early postnatal years. A wide range of pathologies may interfere with normal lung development, some of them leading to permanent sequelae. In this article the long term pulmonary consequences of three intra-thoracic malformations are discussed, all of them potentially being diagnosed in the prenatal period.
Section snippets
Congenital diaphragmatic hernia
Congenital diaphragmatic hernia (CDH) occurs sporadically with an incidence of 1 in 2200 live births, which means that in the EU-27 (5 421 000 births per annum) one baby with CDH is born every 4 h. The vast majority of cases are left-sided, 13% are right-sided, and bilateral lesions, complete agenesis and other rarities comprise <2%. The presence of associated anomalies, which occurs in ∼40%, is an independent predictor of neonatal death. In isolated CDH, several tertiary centers report a rate
Esophageal atresia
Esophageal atresia (EA) is an uncommon malformation with an estimated incidence of one in 3000 (Figure 3). It is often associated with tracheo-esophageal fistula (TEF). Suggestive prenatal signs are the absence of a small stomach bubble, pouch sign (transient filling of the proximal esophagus); late onset polyhydramnios because of swallowing problems quite frequently raises suspicion. The condition is often associated with intrauterine growth restriction. As other pathologies are often
Pulmonary outcome in congenital cardiac and aortic arch anomalies
Congenital cardiac and aortic arch anomalies are often associated with pulmonary complications that may persist despite partial or complete surgical repair. These complications are heterogeneous, but dominated by airway compression, altered lung function, and increased airway responsiveness.
Airway compression is a relatively common complication of congenital cardiac and aortic arch anomalies. The obstruction may be the result of an anomalous relationship between the tracheobronchial tree and
Conflict of interest statement
None declared.
Funding sources
JD, JT and MR are supported by the European Commission FP 6 (eurostec LSHC-CT-2006-037409) and FP7 Marie Curie Industria-Academia Partnership and Pathways (251356), the Fonds Wetenschappelijk Onderzoek Vlaanderen (1.8.012.07.N.02).
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