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Medical and regenerative solutions for congenital diaphragmatic hernia: a perinatal perspective.
[congenital diaphragmatic hernia]
In
the
EU
-
27
,
2
,
100
babies
with
congenital
diaphragmatic
hernia
(
CDH
)
are
born
annually
.
CDH
is
fatal
in
30
%
of
them
.
Experimental
fetal
surgery
in
severe
cases
results
in
a
survival
rate
of
50
to
60
%
at
its
best
.
Failure
is
due
to
insufficient
lung
growth
,
persistent
pulmonary
hypertension
or
prematurity
induced
by
the
procedure
.
For
nonsurvivors
alternative
strategies
are
required
.
Survivors
undergo
anatomical
repair
,
but
large
diaphragmatic
defects
are
closed
using
a
patch
.
At
present
the
used
materials
are
less
than
ideal
,
mainly
because
of
recurrence
and
chest
deformation
.
To
overcome
the
above
limitations
,
alternative
medical
therapies
(
pharmacologic
or
cell
therapy
)
that
are
more
potent
and
less
invasive
are
needed
.
Also
a
more
functional
postnatal
repair
may
be
possible
when
using
novel
scaffolds
or
engineered
constructs
.
We
see
a
prominent
place
for
autologous
amniotic
fluid-derived
stem
cells
for
these
novel
strategies
,
which
could
be
prenatally
harvested
following
appropriate
patient
selection
by
noninvasive
imaging
.
Diseases
Validation
Diseases presenting
"which could be prenatally harvested following appropriate patient selection by noninvasive imaging"
symptom
congenital diaphragmatic hernia
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