Prenatal steroids for microcystic congenital cystic adenomatoid malformations

Curran, Patrick F.; Jelin, Eric B.; Rand, Larry; Hirose, Shinjiro; Feldstein, Vickie A.; Goldstein, Ruth B.; Lee, Hanmin

doi:10.1016/j.jpedsurg.2009.10.025

Cited by 146 publications

(74 citation statements)

References 18 publications

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“…The natural history of a fetal lung mass is variable and the overall prognosis depends on the size of the lesion and on the grade of the secondary physiologic derangement caused by compression from the mass on surrounding structures [5][6][7].…”

Section: Original Articlementioning

confidence: 99%

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Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

et al. 2016

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Objectives: The objective of our study is to retrospectively analyze a single-centre series of antenatally detected pulmonary malformations (PM) and to evaluate their postnatal outcome. Materials and Methods:We retrospectively reviewed all prenatally diagnosed PM patients referred to our Centre in the period between January 1999 and December 2014. All cases were diagnosed by one of our Maternal-Fetal Specialists by US examination. Congenital pulmonary airway malformation (CPAM) volume ratio (CVR), development of fetal complications, need for fetal therapy, need for neonatal resuscitation and timing of surgery were analyzed.Results: A total of 70 fetuses were diagnosed with a PM in the period of study. An initial CVR higher than 1.6 was found in 16/70 patients (22.8%); 14/16 developed fetal complications (p<.0001). Fifty-six fetuses (80%) did not develop any complications during pregnancy. To all complicated cases a prenatal treatment was offered, carried out in 12 (1 termination, 1 refusal). Survival rate was 100%. Sixty-three fetuses (90%) were asymptomatic at birth and did not require any neonatal resuscitation. Six patients submitted to fetal therapy and one untreated presented with neonatal respiratory distress, required mechanical ventilation at birth and early surgery in the neonatal period (7/70, 10%).Conclusion: CVR > 1.6 and the presence of fetal complications can be considered as predictors of respiratory distress at birth and of the need for early surgery. Nevertheless, the vast majority of PM are asymptomatic at birth and only a small group of fetuses require prenatal and postnatal treatment and support.

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Section: Original Articlementioning

confidence: 99%

“…Fetuses developing prenatal complications have a worse prognosis, particularly in the presence of hydrops, and fetal intervention is indicated [4,6].…”

Section: Original Articlementioning

confidence: 99%

Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

et al. 2016

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“…Clinically, cardiogenic hydrops typically presents with impaired diastolic ventricular filling (Bellini et al 2009), as seen in GR K/K foetuses (though not in foetuses with cardiomyocytespecific GR knock-out). Glucocorticoids are an effective treatment in hydrops foetalis associated with congenital cystic adenomatoid malformations (CCAM; Tsao et al 2003, Curran et al 2010, although the therapeutic mechanism remains to be ascertained (Leung et al 2005) and may relate to reduced mediastinal shift secondary to glucocorticoid-induced maturation or involution of the lung lesions, restoring cardiac venous return and improving contractility (Knox et al 2006).…”

Section: Glucocorticoids Through Gr Promote Foetal Heart Maturationmentioning

confidence: 99%

Glucocorticoids and foetal heart maturation; implications for prematurity and foetal programming

Rog-Zielinska¹,

Richardson²,

Denvir³

et al. 2013

Journal of Molecular Endocrinology

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Glucocorticoids are steroid hormones, essential in mammals to prepare for life after birth. Blood levels of glucocorticoids (cortisol in most mammals including humans; corticosterone in rats and mice) rise dramatically shortly before birth. This is mimicked clinically in the routine administration of synthetic glucocorticoids to pregnant women threatened by a preterm birth or to preterm infants to improve neonatal survival. Whilst effects on lung are well documented and essential for postnatal survival, those on heart are less well known. In this study, we review recent evidence for a crucial role of glucocorticoids in late gestational heart maturation. Either insufficient or excessive glucocorticoid exposure before birth may alter the normal glucocorticoid-regulated trajectory of heart maturation with potential life-long consequences.

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“…The routine use of prenatal steroids for microcystic congenital cystic adenomatoid malformation seemed to enhance regression (Curran et al, 2010). There are no documented cases on regression of bronchial or lobar bronchial atresia.…”

Section: Prenatal Bronchial Atresiamentioning

confidence: 99%

Lung Diseases - Selected State of the Art Reviews

Irusen¹

2012

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Prenatal steroids for microcystic congenital cystic adenomatoid malformations

Cited by 146 publications

References 18 publications

Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

Glucocorticoids and foetal heart maturation; implications for prematurity and foetal programming

Lung Diseases - Selected State of the Art Reviews

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