Digestive and Gastrointestinal Conditions

Congenital Diaphragmatic Hernia (CDH) Symptoms and Diagnosis

Symptoms of Congenital Diaphragmatic Hernia

Babies with congenital diaphragmatic hernia may have severe trouble breathing. This can develop soon after they are born.

Babies may have trouble breathing because:

  • Their lungs may be smaller than normal.
  • Their hearts may not be able to pump blood easily to the lungs because the walls of the blood vessels are too thick.
  • Their lungs may be moved to one side by organs that slip through the hole between the belly and chest.

Babies with CDH may also have these symptoms:

  • Skin that is bluish in color due to too little oxygen
  • Rapid breathing
  • Fast heart rate

Congenital Diaphragmatic Hernia Diagnosis

In some cases, doctors can see and diagnose CDH before birth, when a pregnant woman gets a routine ultrasound. If this happens in your case, your doctors can work with you before your baby is born to plan treatment your baby will need in the future.

In other cases, there's no sign of CDH before birth. Doctors diagnose the condition after noticing that the baby has trouble breathing. Upon examining the baby, doctors may also find:

  • Irregular chest movements
  • No sounds of breathing on the side that's affected
  • Sounds usually heard in the low belly (bowel) are heard in the chest instead
  • The lower belly (bowel) feels less full than in other babies.

To find out why the baby is having trouble breathing, doctors ask for the baby to have a chest X-ray. This can show that organs from the belly are in the chest instead. The baby's lungs may look smaller than normal or may be pushed to one side.

Doctors may also take an ultrasound image of the baby's heart (echocardiography). This can help them determine how severe the high blood pressure is in your baby's lungs. The seriousness of CDH depends on how much the growth of your baby's lung has been limited by the lack of space in the chest. It also depends on how severe the high blood pressure is in your baby's lungs.

With specialized care, including surgery to fix the hole, most babies with CDH survive, but some do not.

Once they have surgery to fix the hole, some children have no long-term problems from CDH. Others have ongoing health issues, such as frequent colds, asthma, gastroesophageal reflux, feeding problems and curvature to the spine (scoliosis). In the worst cases, children with CDH have ongoing problems with high blood pressure in their lungs and problems with their lungs getting oxygen to their blood.