Abstract
Congenital diaphragmatic hernia (CDH) is a common abnormality affecting 1 in 2,000 gestations. The mortality exceeds 50% despite recent advances in postnatal treatment. The widespread antenatal use of glucocorticoids to induce lung maturation in fetuses at risk of premature delivery suggests a potential for a therapeutic effect in other fetuses with impaired lung development. The parents of three fetuses referred with CDH and features suggesting a poor postnatal prognosis (early diagnosis, liver herniation, and lung area-to-head circumference ratio <1.0, or associated abnormalities) elected to receive maternal betamethasone starting at 24 to 26 weeks' gestation rather than undergo a fetal tracheal plug. All three infants survived and were extubated within 10 days. The long-term use of antenatal steroids in the treatment of CDH may thus be of benefit and warrants further study.
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Accepted: 26 February 2001
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Ford, W., Kirby, C., Wilkinson, C. et al. Antenatal betamethasone and favourable outcomes in fetuses with `poor prognosis' diaphragmatic hernia. Pediatr Surg Int 18, 244–246 (2002). https://doi.org/10.1007/s003830100685
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DOI: https://doi.org/10.1007/s003830100685