Diagnosing Congenital Diaphragmatic Hernia


You really need a doctor to diagnose CDH. If you are seeing symptoms of it you should already be in a hospital. I will say this is one of the biggest reasons that I would never recommend having a home birth. If your baby has undiagnosed CDH when he or she is born, the baby needs medical attention immediately or the baby will go into respiratory distress from a lack of oxygen and die.

Remember that there is no way to prevent CDH. The reason it happens is unknown.

That said, let us go through how CDH is diagnosed.

The Symptoms

There are some very obvious symptoms that are associated with CDH.

  • Blue Colored Skin: When a baby is born, most of the time he or she is blue before the first breath because the baby has not taken in oxygen yet. But if the cyanosis (bluing) continues that is a sign there is not oxygen coming from the lungs.
  • Trouble Breathing: This is the big sign there is something wrong. This is very seriously. The trouble breathing is that the lungs were not properly formed like they were supposed to because of CDH.
  • Rapid Heart Rate: Also known as tachycardia, the rapid heart rate will happen because the heart is working hard to quickly pump the oxygenated blood throughout the body since the lungs are not doing their job
  • Rapid Breathing: Also known as tachypnea, this is where the lungs will try to make up for the lack of oxygen by trying to their job harder and faster to get the oxygen moving throughout the body.
  • Absence of Breath Sounds: Because the lungs are not formed correctly, they will not be working well, making it nearly impossible to hear any sounds of breathing.
  • Sounds in the Chest Area: If you can hear bowel noises up in the chest cavity the bowels may have traveled through the hole in the diaphragm and made it into the chest.
  • Empty Abdomen: If the abdomen seems less full than it should on palpation it could be a sign that the organs have displaced into the chest cavity.

The Diagnosis

The diagnosis will happen from a doctor, usually before the baby is born. The ultrasound will show that the organs are not sitting where they are supposed to be or there may be too much amniotic fluid.

Once the baby is born abnormalities that could be seen in a physical exam will include:

  • Trouble breathing
  • Bowel sounds in the chest
  • Missing breathing sounds on one side of the chest
  • Unusual chest movements
  • Empty feeling abdomen

There are some scans that can be done to confirm the suspected diagnosis. Most doctors will order:

  • X-ray
  • Ultrasound
  • CT scan
  • Arterial blood gases to test for oxygen level

What’s Next?

If surgery can be performed to repair the hole caused by the diaphragm, the doctors will do that as soon as they can. The surgery can involve putting the organs back where they are supposed to be and closing the hole that is in the diaphragm. Without the organ pressure, the lungs should be able to fully expand to take a breath like they need to, but it will take time.

CDH survivors often suffer from ongoing health issues for the rest of their lives, all related to respiratory problems, including colds, asthma, and gastroesophageal reflux. Sometimes children will also have to deal with high blood pressure as well as their lungs working the way that they are supposed to, getting the oxygen moving through the body. This could mean that they use a portable oxygen tank to get a handle on breathing.