1. Life-Saving Effects of Fetal Tracheal Occlusion on Pulmonary Hypoplasia From Preterm Premature Rupture of Membranes
- Author
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Andreas Müller, Annegret Geipel, Winfried A. Willinek, Rüdiger Stressig, Ulrich Gembruch, Thomas Kohl, and K. Tchatcheva
- Subjects
Fetal Membranes, Premature Rupture ,Pulmonary hypoplasia ,Fetal Organ Maturity ,Pregnancy ,medicine ,Humans ,Lung ,Fetus ,Cesarean Section ,business.industry ,Fetoscopy ,Infant, Newborn ,Obstetrics and Gynecology ,Blood flow ,medicine.disease ,Trachea ,Pregnancy Trimester, First ,medicine.anatomical_structure ,Premature birth ,Anesthesia ,Premature Birth ,Gestation ,Female ,business ,Premature rupture of membranes - Abstract
Background Preterm premature rupture of membranes before 22 weeks of gestation may result in severe fetal pulmonary hypoplasia. Fetoscopic tracheal balloon occlusion might result in catch-up pulmonary growth. Case After preterm premature rupture of membranes at 16 weeks of gestation, magnetic resonance imaging at 26 0/7 weeks showed a fetal lung volume of 13 mL and pulmonary blood flow hardly could be detected. Fetoscopic tracheal balloon occlusion was performed at 27 6/7 weeks; within 6 days, fetal lung volume increased to 70 mL and lung blood flow normalized. The fetus was delivered electively at 28 6/7 weeks. Six hours after delivery, the neonate required only 21% oxygen and was extubated after 55 hours. Conclusion Short-term fetoscopic tracheal balloon occlusion may result in rapid normalization of fetal lung volume and blood flow in fetuses with life-threatening pulmonary hypoplasia from preterm premature rupture of membranes before 22 weeks of gestation.
- Published
- 2009