Retrospective study of prenatal diagnosed pulmonary sequestration

Area of Science:

• Fetal Medicine
• Pediatric Surgery
• Congenital Malformations

Background:

• Pulmonary sequestration (PS) is a rare congenital lung malformation.
• Prenatal diagnosis and management are crucial for optimal outcomes.

Purpose of the Study:

• To describe prenatal findings, treatments, and outcomes of fetuses diagnosed with pulmonary sequestration (PS).

Main Methods:

• Retrospective study of 68 fetuses with PS diagnosed via ultrasound.
• Analysis of lesion size, congenital cystic adenomatoid malformation volume ratio (CVR), perinatal course, and postnatal outcomes.
• Evaluation of fetal interventions and surgical treatments.

Main Results:

• Pulmonary sequestration (PS) cases with CVR ≤ 1.6 had excellent survival without hydrops or respiratory distress.
• Cases with CVR > 1.6 showed higher rates of fetal hydrops (58.3%) and postnatal symptoms (83.3%).
• 66 out of 68 fetuses survived, with 45 undergoing successful surgical resection.

Conclusions:

• Pulmonary sequestration (PS) generally has an excellent prognosis.
• A CVR > 1.6 is associated with increased risk of hydrops and postnatal symptoms.
• Fetal intervention selection should not solely rely on CVR before hydrops development; neonatal/infant surgery offers good outcomes.