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During the last ten year period, 78 newborns with congenital diaphragmatic hernia were seen at the Clinica Infantil "La Paz", Madrid. Twenty seven cases died immediately after delivery and 51 were operated. Necropsy findings showed pulmonary hypoplasia and patent ductus arteriosus. Mortality rate in operated cases was 29%. It seems that pulmonary hypoplasia increases pulmonary vascular resistance resulting in a state of fetal circulation with right-to-left shunting through ductus arteriosus. In these cases right to left shunt with umbilical and temporal artery catheters measuring pre and postductal pO2 must be demonstrated. Authors show their experience with two cases of newborns with Bockdalek hernia treated with tolazoline in postoperative period. Both survived.
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