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Defining hydrops and indications for open fetal surgery for fetuses with lung masses and vascular tumors.

Abstract：

PURPOSE:The aim of this study was to identify the most accurate prenatal predictors of outcomes and need for fetal surgery for fetuses with high-risk lung masses and vascular tumors. METHODS:The records of all fetuses with high-risk lung mass (congenital cystic adenomatoid malformation-volume ratio > 1.6 or findings of hydrops) and vascular tumor evaluated between July 2001 and March 2011 were reviewed retrospectively. Hydrops was defined as accumulation of fluid in 2 or more compartments. RESULTS:Of fetuses with high-risk lung mass, hydrops was identified in 46% (11/24). Fetuses with hydrops and an abnormal echocardiogram (n = 8) demonstrated poor survival without fetal surgery (13%) compared with 100% survival in fetuses with hydrops and a normal echocardiogram (n = 3; P = .02). Of 21 fetuses with vascular tumor (11 sacrococcygeal and 8 cervical teratomas; 2 hemangioendotheliomas), hydrops was identified in 29% and an abnormal echocardiogram in 57%. All fetuses with hydrops had an abnormal echocardiogram and either died (n = 5) or required fetal surgery (n = 1). However, all fetuses with abnormal echocardiograms alone (n = 7) survived without fetal intervention. CONCLUSIONS:For fetuses with lung mass, an abnormal echocardiogram in the setting of hydrops is the best predictor of mortality and need for fetal surgery. For fetuses with vascular tumor, hydrops in the setting of high-output physiology best predicts demise and need for fetal surgery.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Cass DL,Olutoye OO,Ayres NA,Moise KJ Jr,Altman CA,Johnson A,Cassady CI,Lazar DA,Lee TC,Lantin MR

doi

10.1016/j.jpedsurg.2011.10.019

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

40-5

issue

1

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(11)00889-X

journal_volume

47

pub_type

杂志文章

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