Fetal pulmonary sequestration complicated hydrops: Successful fetal therapy by thoracoamniotic shunting / 대한산부인과학회지

ABSTRACT

Pulmonary sequestration is development mass of nonfunctioning bronchopulmonary tissue that is separate from the normal tracheobroncheal tree and receives arterial blood from the systemic circulation. Pulmonary sequestration has an excellent prognosis and frequently can be seen to regress spontaneously on serial prenatal sonogram. But in cases with hydrops the prognosis is poor and associated with a high rate of perinatal mortality and severe respiratory insufficiency in the newborn. We report the case of a fetus presenting at 31 weeks with generalized hydrops, bilateral hydrothorax and a left pulmonary hyperechogenic mass, successfully treated by thoracoamniotic shunting using a catheter and amniodrainage. Serial ultrasound showed normal growth and normal amniotic fluid volume. The newborn did not require surgery and long-term outcome was normal. Based on this observation, the natural history of pulmonary sequestration and prenatal management options are reviewed and discussed.