Wan-Ju Wu1, Jin-Chung Shih2, Haruhiko Sago3, Ming Chen4. 1. Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine, Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan. 2. Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan. 3. Fetal Medicine, National Center of Child Health and Development, Tokyo, Japan. 4. Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine, Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan; Department of Life Science, Tunghai University, Taichung, Taiwan. Electronic address: mchen_cch@yahoo.com.
Abstract
OBJECTIVE: We presented a fetus affected by macrocystic lung lesions with progressive hydropic changes during the second trimester, but experienced remarkable resolution of hydrops in the third trimester after a series of in utero interventions. CASE REPORT: A 19-year-old women, G1P0, presented with fetal multilocular thoracic mass and hydropic change at 23+4 weeks of gestation. After non-directive genetic counseling, she opted for intrauterine cyst aspiration followed by intra-cystic OK-432 injection at 24 weeks of pregnancy, as well as sequential thoracoamniotic shunts at 26 weeks and 27+3 weeks of pregnancy when we observed hydrops developed progressively. Finally, the hydrops resolved in the third trimester and a healthy baby was born at 33+3 weeks of pregnancy, in which further surgical intervention was performed at five-month old. CONCLUSION: Thoracoamniotic shunting is a preferred option for all hydropic fetuses resulted from large macrocystic lung lesions to enhance perinatal survival rate.
OBJECTIVE: We presented a fetus affected by macrocystic lung lesions with progressive hydropic changes during the second trimester, but experienced remarkable resolution of hydrops in the third trimester after a series of in utero interventions. CASE REPORT: A 19-year-old women, G1P0, presented with fetal multilocular thoracic mass and hydropic change at 23+4 weeks of gestation. After non-directive genetic counseling, she opted for intrauterine cyst aspiration followed by intra-cystic OK-432 injection at 24 weeks of pregnancy, as well as sequential thoracoamniotic shunts at 26 weeks and 27+3 weeks of pregnancy when we observed hydrops developed progressively. Finally, the hydrops resolved in the third trimester and a healthy baby was born at 33+3 weeks of pregnancy, in which further surgical intervention was performed at five-month old. CONCLUSION: Thoracoamniotic shunting is a preferred option for all hydropic fetuses resulted from large macrocystic lung lesions to enhance perinatal survival rate.