Fetoscopic Endoluminal Tracheal Occlusion

Congenital diaphragmatic hernia (CDH) is a birth defect where abdominal organs herniate into the chest, preventing the lungs from developing fully. Severe CDH carries a high mortality risk. A fetal surgery procedure called FETO (fetoscopic endoluminal tracheal occlusion) involves placing a small balloon in the baby's airway before birth to stimulate lung growth by preventing fluid from escaping. This study offers and evaluates FETO for fetuses with severe left-sided CDH. The study is open to pregnant women aged 18 and older carrying a singleton fetus with a severe left-sided CDH (defined by lung-to-head ratio below 25%), without other lethal abnormalities, between 27 and 30 weeks of pregnancy, with a cervix length greater than 20mm, and who can relocate to within 15 minutes of the treating center for the duration of the balloon placement. Psychosocial readiness (support system, no illicit drug use) is also required. Twin pregnancies, right-sided CDH, maternal HIV or active hepatitis, short cervix, and inability to consent are among the exclusions. The procedure is performed in a specialized fetal surgery center. Participants must live near the center while the balloon is in place and return for its removal. This research matters because CDH with severe lung underdevelopment has a survival rate below 25% without intervention, and FETO represents one of the few options to give these babies a fighting chance.