A live born boy after in-utero thoracentesis because of a large pulmonary congenital cystic adenomatoid malformation
10.3760/cma.j.cn113903-20240310-00189
- VernacularTitle:胎儿巨大肺部囊性腺瘤样畸形宫内胸膜腔穿刺后成功娩出1例
- Author:
Jingxue WANG
1
;
Yu SUN
;
Huixia YANG
;
Lishuang MA
;
Ying WANG
Author Information
1. 北京大学第一医院妇产生殖医学中心，北京 100034
- Keywords:
Intrauterine therapy;
Congenital cystic adenomatoid malformation;
Fetal hydrops
- From:
Chinese Journal of Perinatal Medicine
2024;27(10):856-859
- CountryChina
- Language:Chinese
-
Abstract:
The course, progression, and prognosis of fetal congenital cystic adenomatoid malformation (CCAM) depend on the size of the mass, whether the mediastinum is displaced, changes in fetal hemodynamics, and the occurrence of fetal hydrops, with large CCAM being relatively rare. In this case, a fetus was suspected of having a large CCAM with fetal hydrops and cardiac insufficiency at 27 weeks of gestation. After multiple imaging evaluations and multidisciplinary consultations, a delivery plan and neonatal resuscitation plan were formulated. At 31 +4 weeks of gestation, in-utero thoracentesis and drainage were performed. Postoperatively, the fetal CCAM was reduced compared to before, and the maternal symptoms of chest tightness and shortness of breath were also improved. Three days after the procedure, the mother experienced premature rupture of membranes and delivered a male infant vaginally at 32 weeks of gestation. On the fifth day after birth, the newborn underwent resection of the pulmonary cystic adenomatoid malformation, confirming the diagnosis. Follow-up for two years post-birth showed good prognosis for both the mother and the child. Therefore, when CCAM is detected during pregnancy, thorough in-utero evaluation should be conducted, and a monitoring plan should be developed based on potential perinatal conditions to avoid unnecessary termination of pregnancy. If the pregnancy continues, multidisciplinary evaluation and preparation for perinatal surgery are necessary.
