I have extensive experience managing CDH cases, including prenatal diagnosis, postnatal stabilization, and surgical repair. I have worked closely with multidisciplinary teams, including neonatologists, pediatric surgeons, and respiratory therapists, to optimize outcomes. My approach focuses on evidence-based practices, such as gentle ventilation strategies and ECMO when necessary, to minimize lung injury and improve survival rates.

Prenatal counseling for CDH involves providing families with clear, compassionate information about the condition, potential outcomes, and treatment options. I emphasize a multidisciplinary approach, involving maternal-fetal medicine specialists, neonatologists, and surgeons. I discuss the importance of delivery planning at a center with ECMO capabilities and prepare families for the challenges ahead while offering hope and support throughout the journey.

Stabilizing neonates with CDH involves gentle ventilation to avoid barotrauma, maintaining preductal oxygen saturation, and optimizing hemodynamics. I prioritize avoiding hyperventilation and using permissive hypercapnia to reduce lung injury. Early involvement of ECMO teams is critical for severe cases. I also focus on maintaining normothermia, correcting acidosis, and ensuring adequate perfusion to support organ function during stabilization.

During CDH repair, I anticipate complications such as bleeding, tension pneumothorax, or difficulty closing the diaphragm. I ensure close communication with the anesthesia team to manage hemodynamics and oxygenation. If complications arise, I remain calm, follow established protocols, and adapt the surgical approach as needed. Postoperatively, I monitor for signs of pulmonary hypertension or recurrent herniation and address them promptly.

Long-term follow-up is crucial for CDH patients to monitor for complications such as chronic lung disease, gastroesophageal reflux, and neurodevelopmental delays. I collaborate with pediatricians, pulmonologists, and developmental specialists to provide comprehensive care. Regular assessments of growth, respiratory function, and developmental milestones help identify and address issues early, ensuring the best possible quality of life for these children.