Research: Impact of fetal treatments for congenital diaphragmatic hernia on lung development

Anat Rec (Hoboken)

. 2022 Sep 5.

 doi: 10.1002/ar.25059. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/36065499/

Impact of fetal treatments for congenital diaphragmatic hernia on lung development

Mar Janna Dahl 1Anna Lavizzari 2Jonathan W Davis 3 4Peter B Noble 1Raffaele Dellacà 5J Jane Pillow 1 4

Affiliations expand

Abstract

The extent of lung hypoplasia impacts the survival and severity of morbidities associated with congenital diaphragmatic hernia (CDH). The alveoli of CDH infants and in experimental models of CDH have thickened septa with fewer type II pneumocytes and capillaries. Fetal treatments of CDH-risk preterm birth. Therefore, treatments must aim to balance the need for increased gas exchange surface area with the restoration of pulmonary epithelial type II cells and the long-term respiratory and neurodevelopmental consequences of prematurity. Achievement of sufficient lung development in utero for successful postnatal transition requires adequate intra-thoracic space for lung growth, maintenance of sufficient volume and appropriate composition of fetal lung fluid, regular fetal breathing movements, appropriate gas exchange area, and ample surfactant production. The review aims to examine the rationale for current and future therapeutic strategies to improve postnatal outcomes of infants with CDH.

Keywords: alveolar development; congenital diaphragmatic hernia; fetal research; lung hypoplasia.

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