Encouraging Early Clinical Experience with Deliberately Delayed Temporary Fetoscopic Tracheal Occlusion for the Prenatal Treatment of Life-Threatening Right and Left Congenital Diaphragmatic Hernias

Objective: In order to assess the effect of deliberately delayed percutaneous fetoscopic tracheal occlusion on survival of fetuses with life-threatening congenital diaphragmatic hernia. Methods: Eight fetuses with life-threatening congenital diaphragmatic hernia underwent fetoscopic tracheal balloon occlusion between 29 + 0 and 32 + 4 weeks of gestation. Delayed occlusion was chosen in order to minimize potentially negative pulmonary effects from premature delivery as a result of fetal surgery. In addition, we wanted to become able to provide all available postnatal intensive care treatment means in these patients. Results: Six of the 8 fetuses survived to discharge from hospital. Conclusion: Delayed fetoscopic tracheal balloon occlusion may be rewarded with lung growth sufficient to allow survival of fetuses with life-threatening congenital diaphragmatic hernia.