Retrospective study of prenatal diagnosed pulmonary sequestration
- Haichun ZhangAffiliated withSouthern Medical UniversityGuangdong Women and Children Hospital
- , Junzhang TianAffiliated withSouthern Medical University, Guangdong No.2 Provincial People’s Hospital Email author
- , Zhongping ChenAffiliated withGuangdong Women and Children Hospital
- , Xiaoyan MaAffiliated withGuangdong Women and Children Hospital
- , Gang YuAffiliated withGuangdong Women and Children Hospital
- , Jiangyu ZhangAffiliated withGuangdong Women and Children Hospital
- , Guihua JiangAffiliated withSouthern Medical University, Guangdong No.2 Provincial People’s Hospital
- , Limin WangAffiliated withGuangdong Women and Children Hospital
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To describe the prenatal findings, treatments and outcomes of fetuses with pulmonary sequestrations (PS), which were retrospectively studied.
From May 2010 to January 2013, 292 women were referred to the Guangdong Women and Children Hospital, Guangzhou because obstetric ultrasound had demonstrated fetal lung lesions. In 68 fetuses, the echogenic lung masses were pulmonary sequestrations deriving arterial blood supply from clearly identifiable systemic arteries rather than the pulmonary artery. We examined records of the 68 fetuses and measured the lesions and congenital cystic adenomatoid malformation volume ratio (CVR), provided prenatal counseling and treatment, documented the CVR, location of lesion, gestational age at diagnosis, need for fetal intervention, perinatal clinical course (including the development of hydrops, effusions, and neonatal respiratory distress), gestational age at delivery, postnatal ultrasound and CT, operation treatment, survival and pathology.
There were 68 PS in our study. All of 56 cases with CVR ≤1.6, survived without prenatal hydrops or postnatal respiratory symptoms. In 12 cases with CVR >1.6, 7 cases (58.3 %, 7/12) had hydrops, 10 cases (83.3 %, 10/12) survived, 2 cases (16.7 %, 2/12) of induced abortion, 8 cases (66 %, 8/12) were postnatal symptomatic. There was statistical significant difference in the incidence rate of hydrops and postnatal respiratory symptoms between the PS with CVR ≤1.6 and that with CVR >1.6. 66 cases postnatal survived, two cases of induced abortion. 64 cases had no prenatal treatment, two cases underwent thoracoamniotic shunt. The mean gestational age at birth was 38 weeks (range 34–40 weeks). 21 asymptomatic cases had no surgery. 45 cases (8 symptomatic and 37 asymptomatic) underwent surgical resections, 43 cases without postoperative complications, two cases of postoperative pneumothorax, no wound infection. Postoperative follow-up showed good growth in all surgery cases.
PS specific absence of hydrop was a congenital disorder with an excellent prognosis. CVR >1.6 was associated with fetal hydrops and postnatal symptoms. However, absolute CVR value cannot be used to select fetuses for fetal treatment before the development of hydrops. Surgery of PS in neonates or infants presented a good outcome.
KeywordsPulmonary sequestration Congenital cystic adenomatoid malformation volume ratio Fetal surgery Prenatal diagnosis Hydrops Ultrasound
- Retrospective study of prenatal diagnosed pulmonary sequestration
Pediatric Surgery International
Volume 30, Issue 1 , pp 47-53
- Cover Date
- Print ISSN
- Online ISSN
- Springer Berlin Heidelberg
- Additional Links
- Pulmonary sequestration
- Congenital cystic adenomatoid malformation volume ratio
- Fetal surgery
- Prenatal diagnosis
- Industry Sectors
- Author Affiliations
- 1. Southern Medical University, Guangzhou, Guangdong, China
- 2. Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- 3. Southern Medical University, Guangdong No.2 Provincial People’s Hospital, Guangzhou, Guangdong, China