Long term follow up of children with congenital diaphragmatic hernia

  • Research type

    Research Study

  • Full title

    Patient Survey on Outcomes in Children with Congenital Diaphragmatic Hernia (CDH) to Identify Predictor’s for Poor Outcomes on Fetal Imaging

  • IRAS ID

    209985

  • Contact name

    Paolo De Coppi

  • Contact email

    Paolo.DeCoppi@gosh.nhs.uk

  • Sponsor organisation

    Great Ormond Street Hospital

  • Clinicaltrials.gov Identifier

    not applicable, not applicable

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Congenital diaphragmatic hernia (CDH) is a condition of unknown aetiology occurring in 1 in 2500 live births resulting from a failure in closure of the fetal diaphragm. The diaphragmatic defect results in herniation of the viscera in the embryonic period which then competes for space with the developing lungs. CDH lungs are underdeveloped resulting in respiratory insufficiency in the newborn. Apart from lung problems, these infants under-go a secondary insult which is post-natal closure of the diaphragmatic defect. Half of patients require patches to close the defect and of these one third re-herniate, the majority in the first two year. Chest wall deformities, gastro-oesphageal reflux disease (GERD), anti-reflux surgery and re-operation for obstructive episodes secondary to adhesions are all more common when primary repair is not possible.
    Fetal imaging, magnetic resonant (MR) or ultrasound (US) scanning provides quantitative information on herniating viscera. This can not only be used to predict outcome but can offer more tailored information to be used in the counselling of parents. In this study we would like to look organ position and lung size on our fetal imaging, and establish if there is any relationship between pre-natal therapy and imaging with post-natal lung and gastrointestinal outcomes in survivors. Our partner centres, Barcelona (Maternitat) and Leuven (UZ) have a unique set of patients who undergo fetal intra-tracheal balloon placement in utero to stimulate lung growth.

    We would like to compare outcomes in these patients to the London population who are not offered fetal therapy to find out the long term effects of fetal therapy. We will give patients the opportunity to fill out questionnaires on gastrointestinal and respiratory outcomes. Secondly, we will collect medical data on prenatal and post-natal parameters.

  • REC name

    West of Scotland REC 5

  • REC reference

    18/WS/0108

  • Date of REC Opinion

    15 Jun 2018

  • REC opinion

    Favourable Opinion