Innovative Fetal Therapy for a Giant Congenital Pulmonary Airway Malformation with Hydrops

Klinkner, Denise B.; Atwell, Thomas D.; Trad, Ayssa Telles Abrao; Callstrom, Matthew R.; Qureshi, Muhammad Yasir; Bendel-Stenzel, Ellen; Schenone, Mauro; Ruano, Rodrigo

doi:10.1159/000521690

Cited by 2 publications

(1 citation statement)

References 24 publications

(27 reference statements)

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“…Fetal endoscopic tracheal occlusion therapy for diaphragmatic hernia, radiofrequency thermal ablation for CPAM and thoracoamniotic shunting for hydrothorax are current intrauterine treatment approaches. [20][21][22] In our clinic, only thoracoamniotic shunting procedure was performed for only 5 patients with a diagnosis of hydrothorax among these treatment approaches. After this shunt procedure, healthy fetuses were born in these 3 patients without the need for any other prenatal or postnatal surgery.…”

Section: Resultsmentioning

confidence: 99%

Outcomes of fetal non-cardiac thoracic abnormalities: a single center experience

Kayaoğlu Yıldırım,

Bolluk

2024

J Med Palliat Care / JOMPAC / Jompac

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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.

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Section: Resultsmentioning

confidence: 99%

Outcomes of fetal non-cardiac thoracic abnormalities: a single center experience

Kayaoğlu Yıldırım,

Bolluk

2024

J Med Palliat Care / JOMPAC / Jompac

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Lifesaving Treatments for the Tiniest Patients—A Narrative Description of Old and New Minimally Invasive Approaches in the Arena of Fetal Surgery

Kohl

2022

Children

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Fetal surgery has become a lifesaving reality for hundreds of fetuses each year. The development of a formidable spectrum of safe and effective minimally invasive techniques for fetal interventions since the early 1990s until today has led to an increasing acceptance of novel procedures by both patients and health care providers. From his vast personal experience of more than 20 years as one of the pioneers at the forefront of clinical minimally invasive fetal surgery, the author describes and comments on old and new minimally invasive approaches, highlighting their lifesaving or quality-of-life-improving potential. He provides easy-to-use practical information on how to perform partial amniotic carbon dioxide insufflation (PACI), how to assess lung function in fetuses with pulmonary hypoplasia, how to deal with giant CPAMS, how to insert shunts into fetuses with LUTO and hydrothorax when conventional devices are not available, and how to resuscitate a fetus during fetal cardiac intervention. Furthermore, the author proposes a curriculum for future fetal surgeons, solicits for the centralization of patients, for adequate maternal counseling, for adequate pain management and adequate hygienic conditions during interventions, and last but not least for starting the process of academic recognition of the matured field as an independent specialty. These steps will allow more affected expectant women and their unborn children to gain access to modern minimally invasive fetal surgery and therapy. The opportunity to treat more patients at dedicated centers will also result in more opportunities for the research of rare diseases and conditions, promising even better pre- and postnatal care in the future.

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Innovative Fetal Therapy for a Giant Congenital Pulmonary Airway Malformation with Hydrops

Cited by 2 publications

References 24 publications

Outcomes of fetal non-cardiac thoracic abnormalities: a single center experience

Outcomes of fetal non-cardiac thoracic abnormalities: a single center experience

Lifesaving Treatments for the Tiniest Patients—A Narrative Description of Old and New Minimally Invasive Approaches in the Arena of Fetal Surgery

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