Ans. is 'a' Early respiratory distress leading Neonates presenting with symptoms of respiratory distress within 24 hrs is a poor prognostic sign. The earlier the symptoms arise the worst is the prognosis.Congenital diaphragmatic herniaIt is the herniation of abdominal contents into the thoracic cavity through the diaphragmatic defectThe defect may beposterolateral (Bochdalek hernia)retrosternal (Morgagni hernia)at the esophageal hiatus (hiatal hernia)adjacent to the hiatus (paraesophageal hernia)Although all these defects are congenital, the term congenital diaphragmatic hernia is generally used for Bochdalek hernia.Bochdalek herniaMost Bochdalek hernia are on the left side (~80%) and may rarely be bilateral.Compression of the lung results in pulmonary hypoplasia, involving both the lungs (ipsilateral- contralateral) pulmonary vasculature is also abnormal leading to pulmonary hypertension.Thus the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertension.The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemia.The anteroposterior diameter of the chest may be large along with a scaphoid abdomen.The diagnosis of CDH can be made prenatally by ultrasound.The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gastric air bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the side of the hernia.Historically, the surgical repair of a CDH was considered to be a surgical emergency because it was believed that the abdominal viscera within the chest prevented the ability to ventilate. More recently with the recognition of the role of pulmonary hypertension and pulmonary hypoplasia and the adverse effects of early operative repair on the pulmonary function has caused a policy of delayed repair. Thus most pediatric surgeons wait for a variable period (24 to 72 hrs to allow for stabilization of the infant before doing surgical repair.About contents of the cong. diaphragmatic hernia.Most books of surgery write that any abdomen viscera can herniate.CSDT writes that "Bowel, spleen & liver sometimes herniate into the chest. "