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Encouraging early clinical experience with deliberately delayed temporary fetoscopic tracheal occlusion for the prenatal treatment of life-threatening right and left congenital diaphragmatic hernias.

Thomas Kohl, Ulrich Gembruch, Barbara Filsinger, Rudolf Hering, Jorgen Bruhn, Kristina Tchatcheva, Sebastian Aryee, Axel Franz, Axel Heep, Andreas Muller, Peter Bartmann, Stefan Loff, Stuart Hosie, Wolfgang Neff, Thomas Schaible
Fetal Diagnosis and Therapy 2006
OBJECTIVE: In order to assess the effect of deliberately delayed percutaneous fetoscopic tracheal occlusion on survival of fetuses with life-threatening congenital diaphragmatic hernia.

METHODS: Eight fetuses with life-threatening congenital diaphragmatic hernia underwent fetoscopic tracheal balloon occlusion between 29 + 0 and 32 + 4 weeks of gestation. Delayed occlusion was chosen in order to minimize potentially negative pulmonary effects from premature delivery as a result of fetal surgery. In addition, we wanted to become able to provide all available postnatal intensive care treatment means in these patients.

RESULTS: Six of the 8 fetuses survived to discharge from hospital.

CONCLUSION: Delayed fetoscopic tracheal balloon occlusion may be rewarded with lung growth sufficient to allow survival of fetuses with life-threatening congenital diaphragmatic hernia.

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