Fetal Endoscopic Tracheal Occlusion (FETO) for Congenital Diaphragmatic Hernia (CDH)

Fetal Endoscopic Tracheal Occlusion (FETO) for Congenital Diaphragmatic Hernia (CDH)

Fetoscopic therapy has been rigorously evaluated in infants with this condition. With an isolated diaphragmatic hernia and with specialized care and postnatal surgery, mortality rates approximate 30 percent (Reickert and colleagues, 1998). The major prenatal findings used to identify candidates for fetal therapy—those at risk for lethal pulmonary hypoplasia—include a significant amount of liver within the thorax and a low lung-to-head ratio—the cross-sectional area of the right lung divided by the head circumference. 

The rationale for FETO is that by placing a silicone balloon between the fetal carina and vocal cords, the normal egress of lung fluid is halted, and the lungs will expand despite the presence of abdominal organs in the chest. The balloon is removed at delivery via the ex-utero-intrapartum-treatment (EXIT) procedure

Ref:William's obstretics,chapter 15