A 9-year audit of fetal chest masses in an Australian maternal-fetal medicine cohort.

Gopikrishna, Saranya; Henry, Amanda; Kaur, Simren; Shand, Antonia W; Jiwane, Ashish; Dyer, Kate; Welsh, Alec W

Gopikrishna, Saranya; Henry, Amanda; Kaur, Simren; Shand, Antonia W; Jiwane, Ashish; Dyer, Kate; Welsh, Alec W.

Afiliación

Gopikrishna S; School of Women's & Children's Health, Faculty of Medicine University of New South Wales Randwick New South Wales Australia.
Henry A; School of Women's & Children's Health, Faculty of Medicine University of New South Wales Randwick New South Wales Australia.
Kaur S; Department of Maternal-Fetal Medicine Royal Hospital for Women Randwick New South Wales Australia.
Shand AW; Department of Obstetrics & Gynaecology St George Hospital Kogarah New South Wales Australia.
Jiwane A; Faculty of Medicine University of New South Wales Randwick New South Wales Australia.
Dyer K; School of Women's & Children's Health, Faculty of Medicine University of New South Wales Randwick New South Wales Australia.
Welsh AW; Department of Maternal-Fetal Medicine Royal Hospital for Women Randwick New South Wales Australia.

Australas J Ultrasound Med ; 22(3): 191-199, 2019 Aug.

Article en En | MEDLINE | ID: mdl-34760556

RESUMEN

INTRODUCTION: To assess fetal vs. neonatal diagnoses, pregnancy outcomes and need for surgery in babies prenatally diagnosed with congenital pulmonary airway malformation (CPAM) or bronchopulmonary sequestration (BPS). METHODS: Retrospective single-centre cohort study of fetuses with a prenatal diagnosis of CPAM or BPS between 2006 and 2014. Data collected included serial antenatal ultrasound information and neonatal/infant diagnoses and outcomes. RESULTS: Initial ultrasound diagnosis (n = 63) was CPAM in 51 and BPS in 12: nineteen (30%) fetuses had mediastinal shift and 2 (3%) had hydrops. All neonates with known birth outcome (n = 56) were liveborn. Final diagnosis in 52 infants (83%) with neonatal imaging and/or histopathology confirmed CPAM in 17/44 (39%) and BPS in 6/9 (67%). Of 34 prenatally suspected but unconfirmed CPAM lesions: 10 had no lesion on neonatal imaging, one no neonatal imaging performed, five confirmed BPS, 11 other lung/thoracic lesions, seven were lost to follow-up. There was one infant death. 27/63 infants (43%) had post-natal surgery. More neonates requiring neonatal respiratory support/resuscitation had surgery compared to those who did not (67% vs. 29%, P = 0.008). Patients with suspected CPAM or BPS on both initial and final ultrasound were more likely to have post-natal surgical management than when a lesion was no longer visible on final antenatal ultrasound (68% vs. 23%, P = 0.001). CONCLUSIONS: Over 50% of antenatally suspected CPAM/BPS either regressed or had an alternate post-natal diagnosis. Perinatal outcome was good, with the majority of neonates/infants conservatively managed. Persistently visible antenatal lesion and need for neonatal respiratory support predicted ultimate surgical management.

Palabras clave

bronchopulmonary sequestration; congenital cystic adenomatoid malformation; congenital pulmonary airway malformation; ultrasound

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Australas J Ultrasound Med Año: 2019 Tipo del documento: Article Pais de publicación: Australia

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