Conservative management of foetal lung lesions

Routine antenatal ultrasound screening has identified a variety of malformations which may present as hyperechogenic or cystic lung lesions. Knowledge of the natural history of these lesions in utero and after birth is incomplete, and an exact diagnosis is not always possible. Despite this, an increasing number of interventions and terminations of pregnancy are being undertaken. We advocate a more conservative approach in the management of these lesions. We describe three cases and review the current literature to demonstrate the uncertain natural history of these lesions, the diagnostic difficulties, and some of the medical and ethical problems of intervention.