Postnatal outcomes of sonographically suspected isolated congenital lung anomalies

The aim was to evaluate the prenatal course, postnatal outcome and diagnostic accuracy of fetuses with a prenatal diagnosis of isolated congenital lung anomalies (iCLA).

A retrospective cohort is described from the Amsterdam UMC between January 2007 and January 2022. The CPAM volume ratio (CVR) was calculated. The concordance between prenatal diagnosis and lesion progression was compared to postnatal findings. Postnatal surgical interventions were reported.

This study includes 113 prenatal cases of iCLA. Ten percent (10/100 cases with available CVR) progressed into high-risk lesions (CVR > 1.6), with a negative impact on survival. In total, 108 (95.6%) cases resulted in live birth. Acute respiratory distress was observed in 6.5% (7/108). During postnatal follow-up, the lesion was still detectable in 10/15 (66.7%) cases in which complete regression was seen prenatally. Fifty percent (54/108) of the live-born children required surgical management.

iCLA has a favorable prognosis in pregnancy, however, close prenatal monitoring is advised. Future parents should be informed about the importance of postnatal follow-up since lesions are often persistent even if prenatal scans may no longer have visualized them, as well as the chance of developing respiratory distress and the probability of undergoing surgery.