Outcome predictors for infants with cystic lung disease |
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Authors: | Usui Noriaki Kamata Shinkichi Sawai Toshio Kamiyama Masafumi Okuyama Hiroomi Kubota Akio Okada Akira |
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Institution: | a Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan b Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan |
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Abstract: | Background/purposeThis study aimed at identifying characteristic features indicating congenital cystic adenomatoid malformation of the lung (CCAM) and evaluating the outcome predictors to identify prenatally subgroups of fetuses with significantly different probabilities of mortality or severe respiratory difficulty.MethodsTwenty-eight neonates who had undergone antenatal evaluation for cystic lung disease (CLD) were reviewed retrospectively. The patients were divided into 3 groups according to the severity of their clinical course; mild (n = 7), moderate (n = 13), and severe (n = 8). Ultrasonographic findings in the fetus and their pulmonary lesion were evaluated. The normal lung to thorax transverse area ratio (L/T) was measured by ultrasonography.ResultsHigh echogenicity of the lesion throughout pregnancy and polyhydramnios were frequently seen in CCAM. All of the patients with other CLD showed isoechogenicity at the end of pregnancy. All patients in the severe group had both polyhydramnios and fetal hydrops. L/T was increased in mild and moderate groups, whereas no patient in the severe group had an increase in L/T at the final measurement. Each value of final L/T in the severe group was less than 0.25.ConclusionsThe subgroup of fetuses with an increased probability of mortality or severe respiratory difficulty could be predicted from the combination of polyhydramnios, fetal hydrops, and a final L/T value of less than 0.25. |
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Keywords: | Predictive factor cystic lung disease congenital cystic adenomatoid malformation of the lung pulmonary sequestration prenatal diagnosis |
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