Neonatal outcome of antenatally diagnosed congenital cystic adenomatoid malformations

Ierullo, A. M.; Ganapathy, Ramesh; Crowley, Suzanne; Craxford, L.; Bhide, A.; Thilaganathan, B.

doi:10.1002/uog.1920

Cited by 77 publications

(57 citation statements)

References 13 publications

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“…Mediastinal shift was observed in a large number of fetuses, the rate of 36% obtained for our population being slightly lower than published rates [5][6][7][8] ranging from 45% 5 to 79%. 6 Mediastinal shift has previously been identified as significantly associated with the need for postnatal surgery. 5 In our series, prenatal mediastinal shift was significantly associated with respiratory distress at birth but was not predictive of the severity of symptoms.…”

Section: Figurecontrasting

confidence: 83%

“…1 This frequency is consistent with previously published evaluations, which ranged from 3% to 23%. [5][6][7]11,12 Of interest, early surgical removal of the malformation (ie, within the first 30 days after birth) was required in only a minority of children with severe respiratory symptoms at birth. Spontaneous improvement was observed in 2 of the 6 children on conventional mechanical ventilation and in 3 of the 4 children with noninvasive ventilation.…”

Section: Figurementioning

confidence: 99%

“…3 Many of the previous studies evaluating neonatal respiratory morbidity in children with CPM used crude indicators, such as mortality or the need for immediate surgery. 2,[4][5][6] Only a few have focused on the prevalence of respiratory symptoms at birth, [7][8][9][10][11][12] and the findings of these studies are often limited by an imprecise definition of the respiratory symptoms, the use of a single-center retrospective design, or a small number of patients. The heterogeneity of these studies probably contributed to the wide range of percentages of neonates with respiratory distress reported (13%-49%).…”

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confidence: 99%

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Neonatal Outcomes of Prenatally Diagnosed Congenital Pulmonary Malformations

et al. 2014

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BACKGROUND AND OBJECTIVE: Congenital pulmonary malformations (CPM) are mostly recognized on prenatal ultrasound scans. In a minority of cases, they may impair breathing at birth. The factors predictive of neonatal respiratory distress are not well defined, but an understanding of these factors is essential for decisions concerning the need for the delivery to take place in a tertiary care center. The aim of this study was to identify potential predictors of respiratory distress in neonates with CPM. METHODS: We selected cases of prenatal diagnosis of hyperechoic and/or cystic lung lesions from RespiRare, the French prospective multicenter registry for liveborn children with rare respiratory diseases (2008–2013). Prenatal parameters were correlated with neonatal respiratory outcome. RESULTS: Data were analyzed for 89 children, 22 (25%) of whom had abnormal breathing at birth. Severe respiratory distress, requiring oxygen supplementation or ventilatory support, was observed in 12 neonates (13%). Respiratory distress at birth was significantly associated with the following prenatal parameters: mediastinal shift (P = .0003), polyhydramnios (P = .05), ascites (P = .0005), maximum prenatal malformation area (P = .001), and maximum congenital pulmonary malformation volume ratio (CVR) (P = .001). Severe respiratory distress, requiring oxygen at birth, was best predicted by polyhydramnios, ascites, or a CVR >0.84. CONCLUSIONS: CVR >0.84, polyhydramnios, and ascites increased the risk of respiratory complications at birth in fetuses with CPM, and especially of severe respiratory distress, requiring oxygen supplementation or more intensive intervention. In such situations, the delivery should take place in a tertiary care center.

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Section: Figurecontrasting

confidence: 83%

Section: Figurementioning

confidence: 99%

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confidence: 99%

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Neonatal Outcomes of Prenatally Diagnosed Congenital Pulmonary Malformations

et al. 2014

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“…Overall survival rate of these cases at our centre was 83.6% in the patients operated during neonatal period, which is comparable to western literature. 13,14 The diagnosis of posterior urethral valve was made in only 20% cases, which far below than the western literature and probably represents evolving antenatal ultrasound screening, but comparable to other series reported from India. Palpable urinary bladder was observed in 48.3% of cases, vesicoureteral reflux was observed in 39% cases which were comparable to other reported series form India, but is less than the western literature where VUR was observed in 62% cases.…”

Section: Discussionsupporting

confidence: 55%

Neonatal surgery : A ten year audit from a university hospital

2008

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Neonatal surgery is the flagship and most challenging component of pediatric surgery, which is the youngest subspeciality of surgery. Neonatal surgery carried a survival rate of only 30% three decades ago. In the last decade there has been a significant change in the scenario. Earlier recognition and referral of these anomalies, availability of neonatal intensive care, better preoperative planning, decision, and techniques have lead to the change in the management. This is an audit into the outcome of neonatal surgery from one of the largest units in India over a ten year period. This audit reveals an across the board survival of 65-70% newborns after surgery on nearly two thousand case over a ten year period. It has an important message that while pediatric surgery units expand, risk stratification of surgical newborns and their treatment in suitable units is mandatory to maintain and improve these figures to match international standards over the next decade.

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“…Fetal intervention (eg, thoracoamniotic shunting, laser ablation) and later resectional surgery is a possibility in some of these [4][5][6][7][8]. Conversely, regression or even apparent resolution may also be observed antenatally in a few [5,9]. Nonetheless, most (>90%) are live-born infants but with radiologically obvious parenchymal abnormalities.…”

Section: Introductionmentioning

confidence: 99%