RESUMO
An infant is reported who was identified antenatally to have an extralobar sequestration and a pleural effusion. Chronic drainage of the effusion was achieved by placement of a pleuroamniotic shunt. After delivery the infant underwent several thoracocenteses and then definitive surgery to remove an extralobar sequestration. The postnatal course was documented by lung function measurements.
Assuntos
Sequestro Broncopulmonar/tratamento farmacológico , Doenças Fetais/terapia , Derrame Pleural/cirurgia , Poli-Hidrâmnios/etiologia , Adulto , Sequestro Broncopulmonar/embriologia , Cateterismo , Feminino , Doenças Fetais/etiologia , Doenças Fetais/fisiopatologia , Humanos , Recém-Nascido , Derrame Pleural/embriologia , Poli-Hidrâmnios/fisiopatologia , Poli-Hidrâmnios/terapia , Álcool de Polivinil/farmacologia , Álcool de Polivinil/uso terapêutico , Gravidez , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Testes de Função Respiratória , Fatores de Tempo , Ultrassonografia Doppler em Cores , Ultrassonografia Pré-NatalRESUMO
A substantial proportion of fetuses with severe early onset growth retardation are chromosomally abnormal and in these cases detailed ultrasound scanning will often demonstrate the presence of fetal anatomical defects. Chromosomally normal SGA fetuses with no biochemical abnormalities are likely to be normal small fetuses and seem to develop normally. SGA fetuses with evidence of impaired placental perfusion such as altered fetal cardiovascular dynamics and disturbances in biochemical, haematological, metabolic and endocrine status are at increased of neurodevelopmental delay. Although incomplete, the data collected so far suggest the biochemical changes may be caused by reduced placental transfer of nutrients (e.g. oxygen, glucose and essential amino-acids) and subsequent reduced fetal metabolism leading to high levels of substrates (e.g. triglycerides and non-essential amino-acids) and low levels of tissue products (e.g. thyroid hormone, insulin, platelets and white cells).
