India
This is a 28-year-old-primigravida referred to our service at 36 weeks. A left-sided diaphragmatic hernia with herniation of stomach, small and large bowel was diagnosed. Some cardiac anomalies were suspected including dextroposition, ventricular septal defect, overriding of aorta, severe pulmonary stenosis (Tetralogy of Fallot). There was also a polyhydramnios. The parents were counseled.
A spontaneous vaginal delivery occurred at 38 weeks (2.780g, male, Apgar 3/7). The baby died two hours later. The postnatal karyotype was normal. The anatomopathological study revealed:
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bilateral congenital diaphragmatic hernia including:
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left side: stomach, duodenum, pancreas and spleen
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right side: right lobe of the liver and gallbladder
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cardiac anomalies:
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pulmonary atresia
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ventricular septal defect (severe form of Tetralogy of Fallot)
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atrial septal defect
Note the absence of the stomach in the abdominal section