JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

eISSN: 2717-7505
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Outcomes of fetal non-cardiac thoracic abnormalities: a single center experience
Abstract
Aims: This study planned to evaluate fetal non-cardiac thoracic anomalies, which are less common than other organ systems, in terms of diagnosis, incidence, therapy and prognosis.
Methods: The data of 66 cases who were evaluated in a perinatology department between January 2021 and July 2023 with diagnosis of fetal non-cardiac thoracic abnormalities were analyzed retrospectively.
Results: A total of 66 cases were in our study with a mean maternal age of 28.61±4.9 years and a median gestational week of first assessment at our center of 24 weeks (15-38 weeks). The most common non-cardiac thoracic malformation was congenital diaphragmatic hernia (30 cases, 45.4%), followed by congenital pulmonary airway malformation (CPAM) (17 cases, 25.7%). Termination of pregnancy was performed in 4 cases (6.06%). While genetic testing was carried out in a total of 9 cases (13.9%), no chromosomal abnormality was found in any of these cases. In utero interventional procedure was performed in 5 cases (7.57%) and success was achieved in 3 cases. Ten (58.8%) cases with CPAM lesions were resolved during the late antenatal or postnatal period with expectant management. Surgery was performed in 2 (11.8%) of 17 cases with CPAM.
Conclusion: Deliveries of the FNTA cases should be planned in tertiary centers where necessary intervention and care can be provided. A multi-disciplinary team could demonstrate a crucial role in assuring that the pregnant woman and fetus obtain appropriate treatment and are managed during the antenatal and postnatal periods. US plays a crucial role in the diagnosis and management of FNTA cases during the prenatal period rather than fetal MRI and other diagnostic tools. More than half of the CPAM lesions regressed spontaneously with expectant management.

Keywords : Congenital thoracic malformations, prenatal ultrasound, postnatal treatment

Download Article


1. Walker L, Cohen K, Rankin J, Crabbe D. Outcome of prenatallydiagnosed congenital lung anomalies in the North of England: areview of 228 cases to aid in prenatal counselling. Prenat Diagn.2017;37(10):1001-1007.
2. Pollak M, Gur M, Bronshtein M, Solt I, Masarweh K, BenturL. Incidence of congenital thoracic malformations detected byprenatal ultrasound. Pediatr Int. 2020;62(1):89-93.
3. Bush A. Prenatal presentation and postnatal management ofcongenital thoracic malformations. Early Hum Dev. 2009;85(11):679-684.
4. Hubbard AM, Harty MP, States LJ. A new tool for prenataldiagnosis: ultrafast fetal MRI. Semin Perinatol. 1999;23(6):437-447.
5. Cavoretto P, Molina F, Poggi S, Davenport M, Nicolaides KH.Prenatal diagnosis and outcome of echogenic fetal lung lesions.Ultrasound Obstet Gynecol. 2008;32(6):769-783.
6. Andrade CF, Ferreira HP, Fischer GB. Congenital lungmalformations. J Bras Pneumol. 2011;37(2):259-271.
7. Witlox RS, Lopriore E, Oepkes D. Prenatal interventions for fetallung lesions. Prenat Diagn. 2011;31(7):628-636.
8. Paladini D, Volpe P. Thoracic anomalies. In: Paladini D,Volpe P, edıtors.Ultrasound of congenital fetal anomalies. 2ndedition.2014;p. 233-266.
9. Wall J, Coates A. Prenatal imaging and postnatal presentation,diagnosis and management of congenital lung malformations.Curr Opin Pediatr. 2014;26(3):315-319.
10. Johnson AM, Hubbard AM. Congenital anomalies of the fetal/neonatal chest. Semin Roentgenol. 2004;39(2):197-214.
11. Behram M, Oğlak SC, Acar Z, et al. Fetal cardiac tumors: prenataldiagnosis, management and prognosis in 18 cases. J Turk GerGynecol Assoc. 2020;21(4):255-259.
12. Behram M, Süzen Çaypınar S, Oğlak SC, Sezer S, ÇorbacıoğluEsmer A. Should isolated aberrant right subclavian artery beignored in the antenatal period? a management dilemma. Turk JObstet Gynecol. 2021;18(2):103-108.
13. Gedik Özköse Z, Oğlak SC, Bestel A, Behram M, Süzen ÇaypınarS, Ölmez F, Özdemir İ. Fetal intracranial hemorrhage: prenatalsonographic diagnosis criteria and postnatal outcomes. J TurkGer Gynecol Assoc. 2022;23(4):268-274.
14. Recio Rodríguez M, Martínez de Vega V, Cano Alonso R,Carrascoso Arranz J, Martínez Ten P, Pérez Pedregosa J. MRimaging of thoracic abnormalities in the fetus. Radiographics.2012;32(7):E305-21.
15. Atalay A, Sahin D. Congenital pulmonary malformations fromthe prenatal to the postnatal period: tertiary center experience.ACH Med J 2023;2(4):165-172.
16. Ionescu C. Thoracic Anomalies [Internet]. Congenital Anomalies- From the Embryo to the Neonate. InTech; 2018. Available from:http://dx.doi.org/10.5772/intechopen.71959.
17. Huang M, Gong YH. Treatment of congenital pulmonary airwaymalformation with rare high cystic volume ratio: a case reportand literature review. Medicine (Baltimore). 2023;102(47):e36249.
18. Levine D, Barnewolt CE, Mehta TS, Trop I, Estroff J, Wong G. Fetalthoracic abnormalities: MR imaging. Radiology. 2003;228(2):379-388.
19. Kaya B, Açar DK, Sezer S. Fetal bronchopulmonary malformations:Prenatal diagnosis and perinatal outcomes. İKSSTD. 2020;12(1):34-38.
20. Kosinski P, Wielgos M. Congenital diaphragmatic hernia:pathogenesis, prenatal diagnosis and management - literaturereview. Ginekol Pol. 2017;88(1):24-30.
21. Grandt J, Gottschalk I, Geipel A, et al. Intrauterine thoracoamnioticshunting of fetal hydrothorax with the somatex intrauterineshunt: intrauterine course and postnatal outcome. J Clin Med.2022;11(9):2312.
22. Klinkner DB, Atwell T, Teles Abrao Trad A, et al. Innovative fetaltherapy for a giant congenital pulmonary airway malformationwith hydrops. Fetal Diagn Ther. 2022;49(5-6):250-255.
Article available in :
Volume 5, Issue 1, 2024
Page : 80-84
https://doi.org/10.47582/jompac.1403249
Article Information
Received : 11 Ara 2023
Accepted : 28 Şub 2024
Published : 29 Şub 2024
Corresponding Author :

Gökhan Bolluk: Division of Perinatology, Department of Obstetrics and Gynecology, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkiye

[email protected]
Citation : Kayaoğlu Yıldırım Z, Bolluk G. Outcomes of fetal non-cardiac thoracic abnormalities: a single center experience. J Med Palliat Care. 2024;5(1):80-84.

Read: 150
Cited: 0
Download : 67
_Footer