Types II and III congenital pulmonary airway malformation with hydrops treated in utero with percutaneous sclerotherapy.

Abstract:

OBJECTIVE:To present outcomes of fetuses with congenital pulmonary airway malformation (CPAM) treated with sclerotherapy. METHODS:Retrospective study of 8 patients with a prenatal diagnosis of CPAM type II or III with secondary hydrops treated with percutaneous sclerotherapy using 5% ethanolamine oleate (EO). All patients underwent ultrasonic measurement of the CPAM volume ratio. Results are expressed as median (range). RESULTS:Gestational age at initial sclerotherapy was 22.0 weeks (19.6-31.4); 3 patients underwent 2 procedures. Intrauterine fetal demise (IUFD) occurred in 4 cases; 2 died on postoperative day #1 (one from inadvertent intravascular EO injection); 2 died >6 weeks after the procedure. Preoperative CPAM volume ratio was 3.6 (1.6-7.8) in survivors and 2.7 (1.7-4.7) in those with IUFD. The volume of EO at the initial sclerotherapy procedure was 3 mL (2-5) in survivors and 7 mL (6-10) in IUFD cases. The gestational age at delivery of the 4 survivors was 38.4 weeks (37.4-39.3); all underwent postnatal resection. CONCLUSION:The efficacy of percutaneous sclerotherapy for CPAM types II and III remains in question. Further studies are needed to determine the optimal dose of sclerotherapy agent and the safety and efficacy of this procedure.

journal_name

Prenat Diagn

journal_title

Prenatal diagnosis

authors

Chon AH,Korst LM,Abdel-Sattar M,Llanes A,Ouzounian JG,Chmait RH

doi

10.1002/pd.5266

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

493-498

issue

7

eissn

0197-3851

issn

1097-0223

journal_volume

38

pub_type

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