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CDH is a birth defect where a severe malformation (hole) develops in the diaphragm. It is a major cause of death in infants due to pulmonary hypoplasia, an incomplete development of the lungs, as the diaphragm contributes to the formation and function of the developing lungs.
Research conducted through a randomized trial between May 2008 and July 2010 compared the safety and efficacy of FETO for the treatment of severe isolated CDH. Dr. Rodrigo Ruano, MD, PhD, of the Faculdade de Medicina da Universidade de Sao Paulo, in Sao Paulo, Brazil, led the trial.
Twenty patients were assigned randomly to undergo Fetal Endoscopic Tracheal Occlusion, FETO, and 21 patients were assigned to no prenatal intervention (control) a standard medical practice.
FETO was performed between 26 and 30 weeks' gestation following a well-established protocol under maternal epidural anesthesia.
Delivery of infants in the FETP group occurred at 35.6+2.4 weeks, and at 37.4+1.9 weeks in the control group.
Ten of the twenty (50.0%) infants in the FETO group and one infant out of twenty one (4.8%) in the control group survived. The findings demonstrate that FETO improves the chance of surviving after birth from less than 5% without this treatment to about 50% after this treatment.
The FETO procedure appears to improve survival by enhancing pulmonary growth as a consequence of fetal tracheal occlusion.
"The present study allows the establishment of this treatment as standard care for severe forms of congenital diaphragmatic hernia," Ruano concludes.
Full citation: Ruano et al. A Randomized Controlled Trial of Fetal Endoscopic Tracheal Occlusion Versus Postnatal Management of Severe Isolated Congenital Diaphragmatic Hernia. Ultrasound in Obstetrics & Gynecology; 2011. DOI: 10.1002/uog.10142
About the Author: Rodrigo Ruano, MD, PhD, is affiliated with the Faculdade de Medicina da Universidade de Sao Paulo.
Ultrasound in Obstetrics and Gynecology is the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), Ultrasound in Obstetrics & Gynecology (UOG) is an international, peer-reviewed journal. Published monthly, the journal includes original papers, case reports, reviews, Editorial and Opinion articles, and a letters column. UOG is covered by all the primary indexes including Index Medicus and Current Contents, and is read by Obstetricians, Gynecologists, Radiologists, Pediatricians, Sonographers, Midwives and Radiographers. For more information, please visit http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1469-0705.
Original article: http://www.eurekalert.org/pub_releases/2011-12/w-ipf120911.php