Lesley Walker1, Kelly Cohen1, Judith Rankin2, David Crabbe3. 1. Department of Fetal Medicine, Leeds General Infirmary, Leeds, UK. 2. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. 3. Department of Paediatric Surgery, Leeds General Infirmary, Leeds, UK.
Abstract
OBJECTIVE: To describe data on congenital lung anomalies identified on prenatal ultrasound from two centres in the North of England. METHOD: This retrospective case series includes all cases notified to the Northern Congenital Abnormality Survey from 1990 to 2010 and to Leeds Regional Fetal Medicine Unit 2000-2015. RESULTS: There were a total of 228 cases, 101 from Northern Congenital Abnormality Survey and 127 from Leeds Regional Fetal Medicine Unit. Eight-five per cent were unilateral congenital pulmonary airway malformations (CPAMs), 2% bilateral CPAMs and 11% bronchopulmonary sequestrations. Mediastinal shift was present in 50% of cases, occurring more frequently in macrocystic CPAMs and larger lesions. Polyhydramnios was evident in 28%, and fetal hydrops occurred in 9%. Prenatal regression occurred in 54%, and lesions were no longer visible on ultrasound in 27% at a later gestation. Prenatal intervention was performed in 5% of cases, and postnatal surgical intervention was required in 12% due to ongoing respiratory symptoms. Regression of fetal hydrops occurred in five cases. CONCLUSION: The outcome was favourable in 83% cases. Prenatal regression was common, and macrocystic lesions were less likely to regress than microcystic lesions. No specific prenatal features predicted the need for early surgical intervention. The data analysed in this prenatal series will help when counselling prenatal cases.
OBJECTIVE: To describe data on congenital lung anomalies identified on prenatal ultrasound from two centres in the North of England. METHOD: This retrospective case series includes all cases notified to the Northern Congenital Abnormality Survey from 1990 to 2010 and to Leeds Regional Fetal Medicine Unit 2000-2015. RESULTS: There were a total of 228 cases, 101 from Northern Congenital Abnormality Survey and 127 from Leeds Regional Fetal Medicine Unit. Eight-five per cent were unilateral congenital pulmonary airway malformations (CPAMs), 2% bilateral CPAMs and 11% bronchopulmonary sequestrations. Mediastinal shift was present in 50% of cases, occurring more frequently in macrocystic CPAMs and larger lesions. Polyhydramnios was evident in 28%, and fetal hydrops occurred in 9%. Prenatal regression occurred in 54%, and lesions were no longer visible on ultrasound in 27% at a later gestation. Prenatal intervention was performed in 5% of cases, and postnatal surgical intervention was required in 12% due to ongoing respiratory symptoms. Regression of fetal hydrops occurred in five cases. CONCLUSION: The outcome was favourable in 83% cases. Prenatal regression was common, and macrocystic lesions were less likely to regress than microcystic lesions. No specific prenatal features predicted the need for early surgical intervention. The data analysed in this prenatal series will help when counselling prenatal cases.