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Intrauterine Ultrasound-Guided Laser Coagulation as a First Step for Treatment of Prenatally Complicated Bronchopulmonary Sequestration: Our Experience and Literature Review.
- Source :
-
European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie [Eur J Pediatr Surg] 2022 Dec; Vol. 32 (6), pp. 536-542. Date of Electronic Publication: 2022 Mar 14. - Publication Year :
- 2022
-
Abstract
- Introduction: Prenatal ultrasound-guided laser coagulation (USLC) for complicated bronchopulmonary sequestrations has been described but a consensus on the procedure and on the following management is still lacking. We present our experience and provide a literature review.<br />Methods: Retrospective review of patients treated in our center. Literature review and combined analysis of perinatal data were performed.<br />Results: Five cases were treated at our center, all presenting with severe hydrothorax. Four met the criteria for fetal hydrops. Four cases underwent postnatal computed tomography (CT) scan: in one case, there was no evidence of persistent bronchopulmonary sequestration. The other three underwent thoracoscopic resection, in two, a viable sequestration was found. Including our series, 57 cases have been reported, with no mortality and a success rate of 94.7%. Mean gestational age (GA) at the procedure was 28 ± 3.4 weeks and mean GA at birth and birth weight (BW) were 38.6 ± 2.3 weeks and 3,276 ± 519.8 g, respectively. In 80.6% of the cases investigated postnatally, a residual mass was found, 50% of cases who showed prenatal arterial flow cessation had a persistent sequestration postnatally, and 26.3% of cases underwent postnatal sequestrectomy. Both patients in our series had pathology examination confirming a viable bronchopulmonary sequestration.<br />Conclusion: Prenatal USLC seems to be a valid option for bronchopulmonary sequestration complicated by severe hydrothorax and/or fetal hydrops. Authors believe that this procedure should aim to reverse fetal distress and allow pregnancy continuation, and it should not be considered a definitive treatment. The currently available data do not support changes of the common postnatal management.<br />Competing Interests: None declared.<br /> (Thieme. All rights reserved.)
- Subjects :
- Pregnancy
Infant, Newborn
Female
Humans
Infant
Hydrops Fetalis etiology
Hydrops Fetalis surgery
Laser Coagulation adverse effects
Ultrasonography, Prenatal adverse effects
Ultrasonography, Prenatal methods
Ultrasonography, Interventional
Bronchopulmonary Sequestration complications
Bronchopulmonary Sequestration diagnostic imaging
Bronchopulmonary Sequestration surgery
Hydrothorax diagnostic imaging
Hydrothorax etiology
Hydrothorax surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1439-359X
- Volume :
- 32
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
- Publication Type :
- Academic Journal
- Accession number :
- 35288883
- Full Text :
- https://doi.org/10.1055/s-0042-1744149