The Indian Journal of Pediatrics

, Volume 84, Issue 8, pp 629–635 | Cite as

Management of Congenital Diaphragmatic Hernia in Newborn — Paradigm Shift and Ethical Issues

Review Article


Management of congenital diaphragmatic hernia (CDH) begins soon after it is detected, whether antenatally or postnatally. Assessment of the severity of the condition, associated congenital anomalies, maternal health and related issues, weight of the fetus/baby, mode of delivery, timing of delivery, immediate appropriate management of the baby with CDH at birth, appropriate utilization of available treatment modalities as well as infrastructure of the treating institute have an impact on the outcome of the neonate. Survival without significant long-term/permanent morbidity is considered as good outcome. With advances in antenatal diagnosis, several legal and ethical considerations have cropped up. While on one hand there are proponents of early antenatal diagnosis and medical termination of pregnancy (MTP), on the other hand there are several socio-cultural groups who look upon human life as precious and argue against MTP. There is an ongoing ethical battle between maternal vs. fetal rights; there is no way to put a lid on the controversy whether the mother be allowed to choose in favor of MTP after being aware of the anomalous fetus or, we must attempt to save every fetus irrespective of the antenatal diagnosis of life-threatening anomalies. Notwithstanding, appropriate assessment of the condition, thorough counseling and sound evidence-based decisions could avert ethical dilemma in most cases. This review article provides information about the various choices available in the diagnostic and treatment armamentarium, though it should be kept in mind that the entire spectrum of management strategies may not be universally available.


Congenital diaphragmatic hernia Paradigm shift Antenatal diagnosis Intervention Postnatal management 



YKS: Retrieval of reference material. SNB: Compiled, compared, summarized the manuscript and will act as guarantor for the paper.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding



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Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  • Sushmita Nitin Bhatnagar
    • 1
  • Yogesh Kumar Sarin
    • 2
  1. 1.Department of Pediatric SurgeryB.J.Wadia Hospital for ChildrenMumbaiIndia
  2. 2.Department of Pediatric SurgeryMaulana Azad Medical CollegeNew DelhiIndia

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