Vanishing fetal lung malformations: Prenatal sonographic characteristics and postnatal outcomes.

Abstract:

BACKGROUND/PURPOSE:The purpose of this study was to examine the natural history and outcomes of prenatally diagnosed lung masses that appear to undergo complete regression before birth. METHODS:An IRB-approved retrospective review was performed on 100 consecutive fetuses with a congenital lung malformation at a single fetal center. Prenatal and postnatal imaging as well as outcomes of vanishing fetal masses was analyzed and compared to those with persistent fetal masses. RESULTS:Seventeen lesions (17%) became sonographically undetectable at 35.3 ± 2.3 weeks gestation. Vanishing fetal masses were associated with microcystic disease (100% vs. 69%, p=0.005) and a low initial congenital pulmonary airway malformation volume ratio (CVR; 0.31 ± 0.35 vs. 0.70 ± 0.66, p=0.002) when compared to those with persistent fetal lesions. Based on postnatal CT imaging and pathology data, 10.3% of all fetal masses completely regressed. The positive predictive value and negative predictive value of prenatal ultrasound for detecting lung malformations in late gestation were 96% and 43%, respectively. All infants with vanishing fetal lesions were asymptomatic at birth and were more likely to be managed nonoperatively (75% vs. 22%, p<0.0001) when compared to infants with persistent fetal masses. CONCLUSIONS:Vanishing lung lesions late in gestation are relatively common and are associated with a low CVR and microcystic disease.

journal_name

J Pediatr Surg

authors

Kunisaki SM,Ehrenberg-Buchner S,Dillman JR,Smith EA,Mychaliska GB,Treadwell MC

doi

10.1016/j.jpedsurg.2015.03.025

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

978-82

issue

6

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(15)00196-7

journal_volume

50

pub_type

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