TY - JOUR
T1 - Antenatal assessment and postnatal outcome of fetal echogenic lung lesions
T2 - a decade’s experience at a tertiary referral hospital
AU - Kane, Stefan C.
AU - Da Silva Costa, Fabrício
AU - Crameri, Joseph A.
AU - Reidy, Karen L.
AU - Kaganov, Helen
AU - Palma-Dias, Ricardo
PY - 2019/3/4
Y1 - 2019/3/4
N2 - Introduction: Fetal echogenic lung lesions (ELL) are the commonest pulmonary pathology diagnosed on antenatal sonography, and include congenital pulmonary airway malformations (CPAMs) and bronchopulmonary sequestrations. This study aimed to evaluate the predictive utility of the CPAM volume ratio (CVR) at presentation in a series of fetuses with ELLs at a tertiary Australian referral hospital. Material and methods: Retrospective cohort study of all pregnancies with a prenatal diagnosis of an isolated fetal echogenic lung lesion managed at the Royal Women’s Hospital, Victoria, Australia, between 2005 and 2015. Data were obtained from electronic ultrasound image databases and medical records. Results: Sixty-five cases were included in the final analysis. The mean gestation at presentation was 22 weeks and 6 d, and the mean CVR was 0.66. Hydrops was evident in four cases at presentation, and did not develop subsequently in any other case. Significant perinatal concerns–fetal/neonatal demise, hydrops, requirement for neonatal intubation/ventilation, or surgery in the first year of life–did not occur with or following a CVR at presentation of <0.45. The survival rate at 1 year was 95%. Discussion: The CVR is a potentially useful tool to assess all fetal ELLs, and not just those presumed to be CPAMs. A CVR at presentation of <0.45 was associated with favourable outcomes.
AB - Introduction: Fetal echogenic lung lesions (ELL) are the commonest pulmonary pathology diagnosed on antenatal sonography, and include congenital pulmonary airway malformations (CPAMs) and bronchopulmonary sequestrations. This study aimed to evaluate the predictive utility of the CPAM volume ratio (CVR) at presentation in a series of fetuses with ELLs at a tertiary Australian referral hospital. Material and methods: Retrospective cohort study of all pregnancies with a prenatal diagnosis of an isolated fetal echogenic lung lesion managed at the Royal Women’s Hospital, Victoria, Australia, between 2005 and 2015. Data were obtained from electronic ultrasound image databases and medical records. Results: Sixty-five cases were included in the final analysis. The mean gestation at presentation was 22 weeks and 6 d, and the mean CVR was 0.66. Hydrops was evident in four cases at presentation, and did not develop subsequently in any other case. Significant perinatal concerns–fetal/neonatal demise, hydrops, requirement for neonatal intubation/ventilation, or surgery in the first year of life–did not occur with or following a CVR at presentation of <0.45. The survival rate at 1 year was 95%. Discussion: The CVR is a potentially useful tool to assess all fetal ELLs, and not just those presumed to be CPAMs. A CVR at presentation of <0.45 was associated with favourable outcomes.
KW - Bronchopulmonary sequestration
KW - congenital pulmonary airway malformation
KW - fetal echogenic lung lesion
KW - hydrops fetalis
KW - prenatal
KW - ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=85031499905&partnerID=8YFLogxK
U2 - 10.1080/14767058.2017.1388367
DO - 10.1080/14767058.2017.1388367
M3 - Article
C2 - 28974162
AN - SCOPUS:85031499905
SN - 1476-7058
VL - 32
SP - 703
EP - 709
JO - The Journal of Maternal-Fetal & Neonatal Medicine
JF - The Journal of Maternal-Fetal & Neonatal Medicine
IS - 5
ER -