Respiratory Distress In Term Infants: Diaphragmatic Hernia

Question 1

This occurs in 1 in….births

Answer 1

4000

Question 2

How are many now diagnosed?

Answer 2

Antenatal USS

Question 3

In newborn period, how does it usually present?

Answer 3

Failure to respond to resuscitation or as respiratory distress

Question 4

Describe what happens in most cases

Answer 4

There is a left sided herniation of abdominal contents through the posterolateral foramen of the diaphragm

Question 5

What signs will be present?

Answer 5

Apex beat and heart sounds displaced to the right side of the chest
Poor air entry in left chest
Signs of respiratory distress

Question 6

Would could vigorous resuscitation cause?

Answer 6

A pneumothorax in the normal lung

Question 7

How is the diagnosis confirmed?

Answer 7

X ray of chest and abdomen

Question 8

Once diagnosis is suspected, what should be done?

Answer 8

Large nasogastric tube passed and suction applied to prevent distension of intrathoracic bowel

Question 9

How is the hernia repaired?

Answer 9

Surgically

Question 10

What is the main problem in infants with this condition?

Answer 10

Pulmonary hypoplasia - compression of the herniated viscera rough out pregnancy prevents development of the lung in the fetus