María V. Fraga, Gabriel Altit, Bradley A. Yoder, Shazia Bhombal
Children’s Hospital of Philadelphia, Perelman School of Medicine and University of Pennsylvania. McGill University. University of Utah School of Medicine. Children’s Healthcare of Atlanta/Emory University.
United States and Canada
Seminars in Fetal and Neonatal Medicine
Semin Fetal Neonatal Med 2025;
DOI: 10.1016/j.siny.2025.101657
Abstract
Congenital diaphragmatic hernia (CDH) is associated with high neonatal morbidity and mortality, often due to complex cardiovascular physiology and ventricular dysfunction. Echocardiography is a critical tool for assessing cardiac anatomy, ventricular performance, pulmonary hypertension, and shunt dynamics in both the prenatal and postnatal periods. Early echocardiographic evaluation can identify high-risk physiologic phenotypes and guide targeted interventions, yet optimal timing and frequency remain uncertain. This review outlines the role of fetal and neonatal echocardiography in CDH, highlights view-specific imaging strategies, and discusses key physiologic patterns. While early imaging may inform management, it must be interpreted in context to avoid unnecessary interventions. A targeted, phenotype-driven approach to echocardiography can support individualized care. Further research is needed to establish standardized protocols and determine the impact of echocardiographic timing on outcomes in this vulnerable population.
Category
Class III. Pulmonary Hypertension Associated with Lung Hypoplasia
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Review Articles Concerning Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No