Congenital Diaphragmatic Hernia

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A congenital diaphragmatic hernia is a serious birth defect that is identified on a routine ultrasound during pregnancy or shortly after your baby is born. If your baby has the condition, they will need surgery to repair the defect. Our team has the experience and resources to care for your baby -- during delivery, after birth, throughout surgery, and as they grow -- to ensure the best-possible outcome.

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What Is a Congenital Diaphragmatic Hernia?

A congenital diaphragmatic hernia occurs when the diaphragm -- the muscle that separates the chest from the abdomen -- fails to fuse completely and leaves a space for the stomach, intestines, and liver to move into the chest. This can keep the lungs from growing properly. Small and underdeveloped lungs, referred to as pulmonary hypoplasia, can result in significant breathing problems including pulmonary hypertension (high blood pressure in the lungs).

Call for an Appointment or Second Opinion

Please call 919-681-3670. Our high-risk clinical nurse specialist will help make your arrangements.

Diagnosis and Planning for Delivery

A congenital diaphragmatic hernia is usually diagnosed on an ultrasound during a routine prenatal care visit. If it is suspected, you will be referred to our fetal diagnostic center.

Comprehensive Imaging

A diagnosis of congenital diaphragmatic hernia will be confirmed through high-resolution ultrasound and a fetal MRI. These tests create detailed images of your unborn baby.

A Team of Pediatric Specialists

Depending on the organs involved, your child’s team of specialists may include perinatologists, neonatologists, pediatric cardiologists, pediatric anesthesiologists, and pediatric general surgeons. As a team, they develop the safest plan for your child’s delivery and after-birth care. They will explain all of your options throughout the treatment process.

High-Risk Perinatal Nurse Coordinates Your Care

If you are currently pregnant and your baby has been diagnosed with a congenital diaphragmatic hernia (CDH), our high-risk perinatal clinical nurse specialist will help you throughout the prenatal process. In addition to answering your questions, they will:

Obtain your medical records from your prenatal appointments including initial ultrasound reports and MRI scans
Schedule your appointments with specialists at the Duke Fetal Diagnostic Center and with perinatologists, surgeons, and neonatologists who are involved in your and your baby's care
Schedule a tour of Duke's birthing center, neonatal intensive care unit (NICU), and pediatric intensive care unit (PICU)
Help set up nearby lodging for you during your baby’s admission, if needed

Delivering Your Baby at Duke

If your baby is delivered at Duke University Hospital, your child will benefit from the expertise and resources needed to care for children with congenital diaphragmatic hernia and the complications that can follow. Our perinatologists are experts in managing complicated pregnancies and deliveries, and our neonatologists staff our Level IV NICU, a designation that indicates we provide the highest level of care for sick infants.

If You Deliver Elsewhere

If your baby is delivered at another hospital, we can arrange for immediate transportation to Duke, where care will begin right away.

Our Locations

Duke Health offers prenatal testing and clinics where you and your child can receive care throughout the Triangle. Find one near you.

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After Your Baby's Birth

Our pediatric surgeons are recognized for the high-quality care they provide. Duke Children’s Hospital has been designated a top-level performer in surgical care by the American College of Surgeons. The Level 1 designation recognizes our commitment to providing the safest and highest-quality surgical care for our young patients. It also recognizes our specialists and resources that aren’t available at other hospitals.

Surgery

Depending on your baby’s condition, surgery to repair the diaphragm may be performed soon after birth or in the days/weeks that follow. Our pediatric surgeons are skilled in using minimally invasive approaches through tiny incisions to move your child’s abdominal organs down from the chest and close the hernia.

Heart-Lung Machine (ECMO)

If necessary, your child may be on a heart-lung machine called extracorporeal membrane oxygenation (ECMO) before and after surgery. ECMO oxygenates your baby’s blood outside the body, which gives the heart and lungs time to rest. We are a major referral center for babies who need ECMO.

Support for You and Your Family

Before, during, and after your delivery, you and your family may receive support from our family-friendly resources. Our social support services include onsite social workers, lactation consultants, a family resource center, discharge planners, and home care services.

Long-Term Follow-Up for Your Baby

Your baby’s care may continue long after he or she leaves the hospital. Babies with congenital diaphragmatic hernia may be put on medications to control pulmonary hypertension. Additional procedures may be needed to prevent or manage acid reflux, another common condition that can develop. Feeding tubes may be needed as well, depending on the severity of your child’s condition. In all cases, our pediatric experts remain your partners in your child’s care and development.

Related Information

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 03/24/2023 by

Henry E. Rice, MD | Pediatric Surgeon