What You Need to Know About Congenital Diaphragmatic Hernia Everyday Health Menu NewslettersSearch Hernia What You Need to Know About Congenital Diaphragmatic Hernia Babies born with a defect called congenital diaphragmatic hernia have trouble breathing, and need surgery. Here are the facts. By Denise SchipaniMedically Reviewed by Justin Laube, MD Reviewed: April 25, 2018 Medically Reviewed Illustration of a diaphragmatic hernia in a fetus. The stomach and part of the intestines go up through the diaphragm in the chest cavity, preventing the lungs from developing properly.Alamy Congenital Many cases of CDH are discovered in a routine Immediately after birth, the baby is put on a ventilator to help him breathe, and another tube may be threaded down into the stomach to keep air from further expanding the intestines. Another intervention some babies need is called extracorporeal membrane oxygenation (ECMO), a treatment in which a pump circulates the baby’s blood through an artificial lung. “About a quarter of babies need ECMO as a bridge to get them stabilized, and if they need it, it’s usually in that first day,” says Hedrick. Once the baby is stabilized, he’s brought to the neonatal intensive care unit (NICU). After that, she says, “it’s a day-to-day wait in terms of seeing how the baby’s heart is functioning and how he’s responding to therapy,” before surgery can occur. Surgical repair of CDH involves an incision below the baby’s ribs. The surgeon brings the organs that have migrated into the chest back down into place, and then repairs the diaphragm. “About 70 percent of the time we use a Gore-Tex patch to replace the missing part of the diaphragm,” says Hedrick. Also in some cases, such as when the liver is up in the chest cavity and must be brought down, the abdomen is too “crowded” for the surgical wound to be closed right away, and another type of mesh or patch is kept over the area. The Future for Babies With CDH Prognosis and Complications The good news is that the current survival rate for CDH babies is over 80 percent, says Hedrick, a significant increase from even a decade ago. Some factors that impact recovery include whether the baby also has other birth defects, and how severe the pulmonary hypoplasia is. Another important factor is whether the liver is among the organs that herniated. “The liver is a solid, nonyielding organ, so the lung has even more trouble growing against it,” explains Hedrick. Post-surgery, the goal is to slowly wean the infant off breathing support, and start normal feeding, something that must wait until the digestive system begins to work. 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