Presentation
A congenital diaphragmatic hernia was detected on a routine pregnancy ultrasound at 19 weeks of gestation.
Patient Data
The stomach can be seen herniated into the chest cavity. The heart is seen on the right side of the chest. The right lung is well developed. No other associated congenital anomalies are visible. Amniotic fluid volume is normal. The thoracic circumference is greater than the abdominal circumference.
Case Discussion
Ultrasound is the first modality for the diagnosis of fetal congenital diaphragmatic hernia (CDH). The anomaly develops in the first trimester because the development of the diaphragm is complete by the 9th week of gestation. In our case, initially, it appeared like a case of dextrocardia. Still, on careful examination, the fetal stomach was found herniated into the left thoracic cavity, pushing the heart to the right side of the chest. The presence of dextrocardia should alert the ultrasonologist to search for the secondary causes of the same. Lung area to head circumference ratio (LHR) could be a prognostic measure in cases of congenital diaphragmatic hernia (CDH) because it indicates the development of the other lung 1.