Vol 86, No 1 (2015)
ARTICLES
Fetal therapy – evaluation of intrauterine therapy in congenital cystic adenomatoid malformation of the lung (CCAM)
Krzysztof Szaflik, Magdalena Litwińska, Przemysław Oszukowski, Anna Piaseczna-Piotrowska, Ewelina Litwińska, Waldemar Krzeszowski, Ewa Gulczyńska, Iwona Maroszyńska, Katarzyna Janiak
DOI: 10.17772/gp/1892
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Ginekol Pol 2015;86(1).
Vol 86, No 1 (2015)
ARTICLES
Abstract
Objectives: The aim of the study was to evaluate the efficiency of intrauterine treatment of large cysts in fetal lungs using thoracoamniotic shunts. Material and methods: Our observational retrospective study was carried out on a series of 8 fetuses who underwent thoracoamniotic shunting after sonographic statement of large macrocystic lesions in the lungs at the Department of Gynecology, Fertility and Therapy of the Fetus, Polish Mother’s Research Institute, between 2009-2014. Results: Mean gestational age at shunt insertion was 26.6 (range 18-33) weeks. Marked mediastinal shift in theechocardiographic examination was observed in all of the investigated cases. Five fetuses had polyhydramion, with 4 hydropic cases. Out of the remaining 4 fetuses without impaired cardiac function, 3 had very large lesions at initial presentation and 1 had a lesion that was rapidly increasing in size. Shunt insertion was successful in all cases. Only one patient went into premature labor (at 36 weeks of gestation). Mean gestational age at delivery was 38.2 weeks. Cesarean section was necessary in the half of the patients due to obstetric complications. All newborns underwent
resection of the lesions. Three of them were operated in the first month after birth. The rest of the operations were postponed. Prenatal diagnosis of congenital cystic adenomatoid malformations was confirmed by pathologists in all cases. Conclusion: Intrauterine therapy of macrocystic lesions in fetal lungs enables to achieve good perinatal outcome. It needs to be considered in every case of a fetus with developing impaired cardiac function.
Abstract
Objectives: The aim of the study was to evaluate the efficiency of intrauterine treatment of large cysts in fetal lungs using thoracoamniotic shunts. Material and methods: Our observational retrospective study was carried out on a series of 8 fetuses who underwent thoracoamniotic shunting after sonographic statement of large macrocystic lesions in the lungs at the Department of Gynecology, Fertility and Therapy of the Fetus, Polish Mother’s Research Institute, between 2009-2014. Results: Mean gestational age at shunt insertion was 26.6 (range 18-33) weeks. Marked mediastinal shift in theechocardiographic examination was observed in all of the investigated cases. Five fetuses had polyhydramion, with 4 hydropic cases. Out of the remaining 4 fetuses without impaired cardiac function, 3 had very large lesions at initial presentation and 1 had a lesion that was rapidly increasing in size. Shunt insertion was successful in all cases. Only one patient went into premature labor (at 36 weeks of gestation). Mean gestational age at delivery was 38.2 weeks. Cesarean section was necessary in the half of the patients due to obstetric complications. All newborns underwent
resection of the lesions. Three of them were operated in the first month after birth. The rest of the operations were postponed. Prenatal diagnosis of congenital cystic adenomatoid malformations was confirmed by pathologists in all cases. Conclusion: Intrauterine therapy of macrocystic lesions in fetal lungs enables to achieve good perinatal outcome. It needs to be considered in every case of a fetus with developing impaired cardiac function.
Keywords
macrocystic type CCAM / intrauterine therapy / thoracoamniotic shunt
Title
Fetal therapy – evaluation of intrauterine therapy in congenital cystic adenomatoid malformation of the lung (CCAM)
Journal
Ginekologia Polska
Issue
Vol 86, No 1 (2015)
Page views
869
Article views/downloads
3871
DOI
10.17772/gp/1892
Bibliographic record
Ginekol Pol 2015;86(1).
Keywords
macrocystic type CCAM / intrauterine therapy / thoracoamniotic shunt
Authors
Krzysztof Szaflik
Magdalena Litwińska
Przemysław Oszukowski
Anna Piaseczna-Piotrowska
Ewelina Litwińska
Waldemar Krzeszowski
Ewa Gulczyńska
Iwona Maroszyńska
Katarzyna Janiak
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