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Related Experiment Videos

Fetal thoracic lesions

N S Adzick1

  • 1UCSF Fetal Treatment Center.

Seminars in Pediatric Surgery
|May 1, 1993
PubMed
Summary
This summary is machine-generated.

Prenatal diagnosis of fetal lung lesions allows for defining natural history and prognosis. Early intervention, including fetal surgery for hydrops, improves survival rates for congenital lung malformations.

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Area of Science:

  • Medical imaging
  • Fetal medicine
  • Pediatric surgery

Background:

  • Prenatal diagnosis of fetal lung lesions is increasingly common.
  • Understanding the natural history and pathophysiology of these lesions is crucial for management.
  • Congenital cystic adenomatoid malformation of the lung and pulmonary sequestration are significant fetal lung abnormalities.

Observation:

  • Serial sonographic studies provide insights into the natural progression of fetal lung lesions.
  • Hydrops fetalis in fetuses with lung masses indicates a very high risk of fetal or neonatal demise.
  • Some large fetal lung tumors may spontaneously regress during gestation.

Findings:

  • Fetuses with hydrops and lung lesions have undergone successful fetal surgical resection (fetal lobectomy).

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  • Fetuses with lung masses but without hydrops have a favorable prognosis with planned delivery and neonatal surgical intervention.
  • Natural history studies reveal that spontaneous improvement of lung lesions can occur in utero.

    • Implications:

    • Prenatal diagnosis and serial sonography enable tailored management strategies based on lesion type and associated hydrops.
    • Fetal surgery offers a life-saving option for select cases of massive lung lesions with hydrops.
    • Improved understanding of natural history guides decisions regarding timing of delivery and neonatal care, optimizing outcomes for congenital lung disease.