Microcystic congenital pulmonary airway malformation with hydrops fetalis: steroids vs open fetal resection

Loh, Kenneth C.; Jelin, Eric B.; Hirose, Shinjiro; Feldstein, Vickie A.; Goldstein, Ruth B.; Lee, Hanmin

doi:10.1016/j.jpedsurg.2011.10.015

Cited by 56 publications

(27 citation statements)

References 14 publications

(24 reference statements)

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“…In microcystic lesions, open foetal surgery may be indicated [63]. Maternal betamethasone treatment has been suggested to have beneficial effects on large microcystic CPAMs[65,66,67]. Before a decision for any prenatal intervention is taken, it is recommended to characterise the lesion (macro vs. micro, CVR, hydrops) and to identify associated anomalies by US, echocardiogram and/or MRI [68,69].…”

Section: Managementmentioning

confidence: 99%

Prenatal and Postnatal Management of Congenital Pulmonary Airway Malformation

2016

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Congenital pulmonary airway malformation (CPAM) is one of the most common lung lesions detected prenatally. Despite the research efforts made in the past few years, controversy and lack of clarity in the literature still exist regarding nomenclature, classification, pathogenesis and the management of CPAM. Therefore, it is of greatest importance to delineate the natural history of CPAMs and to create a consensus to guide the management and follow-up of these lesions. This review will focus on classification systems, highlighting the most recent advancements in pathogenesis, and current practice in the prenatal diagnosis of CPAM. Strategies of prenatal management and postnatal management will be reviewed. Long-term follow-up, including lung cancer risk, is discussed and an outcome perspective is presented.

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Section: Managementmentioning

confidence: 99%

Prenatal and Postnatal Management of Congenital Pulmonary Airway Malformation

2016

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“…These effects of corticosteroid on haemodynamics may cause a decrease in FHR. Moreover, corticosteroid therapy with β-methasone was reported to be effective for treatment of HF associated with congenital pulmonary airway malformation (CPAM)10 11 and is recommended for the treatment of HF associated with CPAM 2. These observations together with the clinical course of our case raised the possibility that corticosteroid therapy contributed to the resolution of HF in the present case with tachyarrhythmia.…”

Section: Discussionmentioning

confidence: 51%

Resolution of tachyarrhythmia-related fetal hydrops after corticosteroid administration for fetal lung maturation

et al. 2015

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A case of hydrops fetalis (HF) that resolved after corticosteroid therapy despite persisting fetal tachycardia of 190 bpm is reported. The fetus with confirmed normal karyotype had HF in the presence of atrial flutter and sustained ventricular rate of 200-210 bpm at gestational week (GW) 31(-6/7). Aetiologies of HF other than fetal tachyarrhythmia were unlikely in this infant. The patient's family declined pharmacological treatment with maternal digoxin and desired to continue pregnancy with only intensive monitoring of fetal condition. Maternal transplacental β-methasone was given to facilitate fetal lung maturation. The fetal tachyarrhythmia ameliorated to 190 bpm at GW 32(-5/7) and HF gradually disappeared by birth. The otherwise healthy female neonate weighing 3050 g born at GW 37(-0/7) was successfully treated with cardioversion performed 60 min after birth. This case suggested that corticosteroid therapy contributed to the resolution of HF associated with tachyarrhythmia.

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“…afin de pré parer au mieux la naissance, voire d'intervenir en anté natal par des ponctions ou encore la mise en place de drains kysto-amniotiques in utero. La place de la corticothé rapie dans la pré vention de la dé tresse respiratoire né onatale en cas de malformations pulmonaires diagnostiqué es en anté natal reste à dé finir [14].…”

Section: Discussionunclassified