I just had a LGA term baby born through shoulder dystocia; noted with respiratory distress shortly after birth. Placed on HFNC, need ~35% FiO2 on 2 LPM. Xray with right hemidiapragm elevation. Question: How long is prudent to wait for surgical intervention in these babies?

Thanks

Hello! I would suggest to wait, at least for a few weeks. The cases I have come across have resolved spontaneously (but must admit that my experience is limited...)

This paper/case report http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3611918/ suggests that plication of the diaphragm can be indicated around 1 month of age. 

Edited August 24, 201510 yr by Stefan Johansson

Thanks