Prenatally diagnosed congenital lung malformations-A long-term outcome study

Area of Science:

• Pediatric Surgery
• Neonatal Care
• Pulmonology

Background:

• Congenital lung malformations (CLM) are increasingly detected during prenatal screening.
• The natural history and optimal management strategy for prenatally diagnosed CLM remain subjects of ongoing research.
• Expectant management is a potential approach for asymptomatic cases, but requires careful follow-up.

Purpose of the Study:

• To investigate the natural history of children diagnosed with congenital lung malformations (CLM) before birth.
• To evaluate the outcomes of expectant management for prenatally detected CLM in pediatric patients.
• To determine the long-term clinical course and potential complications associated with CLM.

Main Methods:

• Retrospective review of pediatric patients diagnosed with CLM via prenatal ultrasound between 1995 and 2013.
• Analysis of prenatal ultrasound findings, medical records, radiology, and pathology data.
• Longitudinal follow-up of asymptomatic and transiently symptomatic children.

Main Results:

• 159 newborns with fetal lung lesions were identified; 28% were symptomatic at birth.
• 148 asymptomatic or transiently symptomatic infants were followed for a median of 6 years.
• 13% (21 children) became symptomatic later (median age 2.5 years) with infection; none became symptomatic after 5.8 years. No malignancies were found.

Conclusions:

• The majority of children with prenatally diagnosed CLM are asymptomatic at birth and remain so throughout childhood.
• Expectant management appears safe and effective for many cases of congenital lung malformations.
• Continued surveillance until age 10 years is recommended for children with prenatally diagnosed CLM.