International recommendations on neonatal management with congenital diaphragmatic hernia: literature review

Congenital diaphragmatic hernia (CDH) is a defect of diaphragm development which characterized by herniation the abdominal content into chest resulting in pulmonary hypoplasia and hypertension various degrees. Mortality sickness rates among survived children with this pathology remain high all over world. Prenatal diagnostics quality will help to find neonates severe CDH promote mobilization human material resources for optimal management at tertiary level giving medical aid. Attention specialists prenatal ultrasound should be drawn necessity measuring observed/expected lung(to(head ratio location liver fetus. Optimal treatment during preoperative period focused on mild ventilation, avoidance oxygen toxicity, baro/volutrauma hypoplastic lung cardiac support. Administration vasodilator therapy including inhaled nitric oxide extracorporal membrane oxygenation pathogenetically substantiated patients hypertension, surgical correction delayed till stabilization patient's condition. Echocardiography critically important diagnostic method. It enables determine severity myocardial functional disorders, targeted systemic methods that improve hemodynamic function or decrease vascular resistance. Considering an insufficient evidence existing international recommendations, large(scale multi(center randomized studies investigation best prevent, diagnose treat are essential. No conflict interest was declared authors. Key words: congenital hernia; neonate; lung-to-head ratio; hypertension; oxygenation.