Video4 min·Published Sep 2026

FETO for Late-Diagnosed Severe Congenital Diaphragmatic Hernia (CDH) at Cincinnati Children's with Dr. Beth Rymeski

Name: FETO for Late-Diagnosed Severe Congenital Diaphragmatic Hernia (CDH) at Cincinnati Children's with Dr. Beth Rymeski with Dr. Jill Knerath
Description: This video presents a detailed case study of a 24-year-old mother with a late diagnosis of severe congenital diaphragmatic hernia (CDH) at 28 weeks of gestation. Pediatric Surgeon Dr. Beth Rymeski from Cincinnati Children's Hospital highlights the successful application of Fetal Endoluminal Tracheal

With Dr. Beth Rymeski · hosted by Dr. Jill Knerath

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What the experts said9 expert statements · 3 host summaries

When the left lobe of the liver is touching the apex of the left chest in left-sided CDH, the entire hemi-liver has herniated into that side of the chest.

ClinicalBeth Rymeski

The cutoff for severe CDH O/E (observed to expected lung to head ratio) on ultrasound is 25%.

GuidelineBeth Rymeski

In this case, there was a 42% increase in lung volume between balloon placement and removal (left lung volume increased from 1 mL to 23 mL).

ClinicalBeth Rymeski

For a C-section delivery less than a week after FETO balloon removal, intubation on support and surfactant administration were performed.

ClinicalBeth Rymeski

Initial respiratory management included Vyvent (APRV setting), then oscillator, with low dose fentanyl to support blood pressure, eventually returning to Vyvent vent settings.

ClinicalBeth Rymeski

Extubation at 26 days old is pretty good for a severe CDH.

OpinionBeth Rymeski

Discharge at day of life 94 (about three months old) is pretty good for severe CDH.

OpinionBeth Rymeski

Tracheal dilation is a very common finding in babies who had tracheal occlusion because the trachea was stretched out during the course of the pregnancy.

ClinicalBeth Rymeski

Tracheal dilation after FETO is not felt to be clinically impactful in the long run based on follow-up data from kids in Europe.

ClinicalBeth Rymeski

FETO (fetoscopic endotracheal occlusion) uses a fetoscope to insert a balloon into the fetal trachea to temporarily block it, trapping fluid in the lungs to allow expansion and growth.

Host summaryJill Knepprath · not cited in answers

Liver herniation is especially harmful for fetal lung development because the liver is a large and mobile organ, unlike the bowels.

Host summaryJill Knepprath · not cited in answers

Balloon removal after FETO is typically done by week 34.

Host summaryJill Knepprath · not cited in answers