Management of the upper airway and congenital cystic lung diseases in neonates

Nicolai, T.

doi:10.1016/j.siny.2008.08.007

Cited by 12 publications

(5 citation statements)

References 45 publications

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“…Factors predicting or requiring post‐natal surgery have been extensively reported in the literature, and associations between fetal lung lesions and malignant transformation, including rhabdomyosarcoma, used to justify the need for prophylactic surgery by some . Some have recommended early removal of asymptomatic CPAMs at 6–12 months to prevent potential future complications like infection and progression to malignancy, the benefits being perceived to outweigh potential risks of early elective surgery . Conservative management with long‐term follow‐up has been advocated by others with surgery reserved for those with concerning features on CT scan or recurrent infections .…”

Section: Discussionmentioning

confidence: 99%

“…Conservative management with long‐term follow‐up has been advocated by others with surgery reserved for those with concerning features on CT scan or recurrent infections . A younger age at surgery, especially in those who are asymptomatic, has previously been shown to not be associated with differences in post‐operative complication rate, hospital stay and treatment required especially within the first 6 months . Others advocate close follow‐up for asymptomatic babies for 1 year with repeated imaging and surgical excision for persistent lesions .…”

Section: Discussionmentioning

confidence: 99%

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A 9‐year audit of fetal chest masses in an Australian maternal—fetal medicine cohort

Gopikrishna

Henry

Kaur

et al. 2019

Australas J Ultrason Med

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Introduction: To assess fetal vs. neonatal diagnoses, pregnancy outcomes and need for surgery in babies prenatally diagnosed with congenital pulmonary airway malformation (CPAM) or bronchopulmonary sequestration (BPS). Methods: Retrospective single-centre cohort study of fetuses with a prenatal diagnosis of CPAM or BPS between 2006 and 2014. Data collected included serial antenatal ultrasound information and neonatal/infant diagnoses and outcomes. Results: Initial ultrasound diagnosis (n = 63) was CPAM in 51 and BPS in 12: nineteen (30%) fetuses had mediastinal shift and 2 (3%) had hydrops. All neonates with known birth outcome (n = 56) were liveborn. Final diagnosis in 52 infants (83%) with neonatal imaging and/or histopathology confirmed CPAM in 17/44 (39%) and BPS in 6/9 (67%). Of 34 prenatally suspected but unconfirmed CPAM lesions: 10 had no lesion on neonatal imaging, one no neonatal imaging performed, five confirmed BPS, 11 other lung/thoracic lesions, seven were lost to follow-up. There was one infant death. 27/63 infants (43%) had post-natal surgery. More neonates requiring neonatal respiratory support/resuscitation had surgery compared to those who did not (67% vs. 29%, P = 0.008). Patients with suspected CPAM or BPS on both initial and final ultrasound were more likely to have post-natal surgical management than when a lesion was no longer visible on final antenatal ultrasound (68% vs. 23%, P = 0.001). Conclusions: Over 50% of antenatally suspected CPAM/BPS either regressed or had an alternate post-natal diagnosis. Perinatal outcome was good, with the majority of neonates/infants conservatively managed. Persistently visible antenatal lesion and need for neonatal respiratory support predicted ultimate surgical management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A 9‐year audit of fetal chest masses in an Australian maternal—fetal medicine cohort

Gopikrishna

Henry

Kaur

et al. 2019

Australas J Ultrason Med

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“…Existen diferentes abordajes terapéuticos dependiendo del tamaño de la lesión y de la edad al diagnóstico de la misma. En el período prenatal se han realizado drenaje, ablación percutánea o resección intraútero en aquellos fetos con quistes grandes y riesgo de desarrollo de hidrops fetalis, con resultados aceptables según las series [20][21][22][23] . Existe controversia respecto al uso de corticoides antenatales, aunque existen revisiones de casos donde se encuentra regresión de aquellas lesiones con tamaño microquístico 24,25 .…”

Section: Discussionunclassified

Malformación adenomatoidea quística congénita

Antón-Martín

Cuesta-Rubio

López-González

et al. 2011

Rev. chil. pediatr.

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Congenital cystic adenomatous malformationIntroduction: Congenital Cystic Adenomatous Malformation (CCAM) is an infrequent entity due to an alteration in alveolar-pulmonary development. Material and Methods: A descriptive, retrospective study of newborns presenting CCAM in a tertiary care hospital in Madrid, Spain. Results: Seven patients were found. All were full term, normal weight births. Two patients showed respiratory distress at birth. Two chest x-rays were normal. CT scans showed three clear CCAM lesions, four suggestive of hybrid lesions. All were referred to medical centers with pediatric surgery for followup. Discussion: At birth, this pathology may be asymptomatic and appear as a chest x-ray fi nding. Long term management is complicated by infection and malignization. Conservative treatment of asymptomatic patients includes regular follow up of lesions. Surgical treatment is reserved for symptomatic or complicated patients. Conclusions: Prenatal suspicion of CCAM is important since clinical exam and radiology may be normal in neonatal period. Chest CT scans are important in confi rming diagnosis and determining future surgery. More studies are necessary for the proper diagnosis and management of this disorder.

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“…More and more, diagnosis of pulmonary malformations, and in particular of PS, is made antenatally 7–9. This argues of a congenital origin of PS.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary sequestration of the left upper lobe associated with a bronchogenic cyst: Case report of an exceptional association

Barbut¹,

Fernandez²,

Blanc³

et al. 2010

Pediatric Pulmonology

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Intralobar pulmonary sequestration (ILPS) and bronchogenic cyst are rare congenital diseases. We present the first case of the association between an ILPS located in the upper lobe and a bronchogenic cyst. This association has been discovered antenatally in a girl. The cystic lesion has been shown by a fetal MRI and confirmed by a CT scan at 3 weeks of life. She underwent a left upper lobectomy by thoracoscopy at the age of 5 months. Postoperative course was uneventfull. This case confirms the congenital origin of pulmonary sequestration and shows the interest of an early surgery.

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Management of the upper airway and congenital cystic lung diseases in neonates

Cited by 12 publications

References 45 publications

A 9‐year audit of fetal chest masses in an Australian maternal—fetal medicine cohort

A 9‐year audit of fetal chest masses in an Australian maternal—fetal medicine cohort

Malformación adenomatoidea quística congénita

Pulmonary sequestration of the left upper lobe associated with a bronchogenic cyst: Case report of an exceptional association

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