Successful Outcome in a Case of Cystic Adenomatoid Malformation of the Lung Complicated by Fetal Hydrops, Using Extracorporeal Membrane Oxygenation

Abstract

Severe fetal hydrops associated with cystic adenomatoid malformation of the lung inexplicably resolved spontaneously at 33–34 weeks’ gestation. Following postnatal resection of the lesion which was of the macrocystic variety, the infant’s respiratory status deteriorated, requiring 1 week of complicated support with extracorporeal membrane oxygenation. The baby survived and was discharged.

Large fetal congenital cystic adenomatoid malformations: growth trends and patient survival

“…Although there may be some slight variation in the definition of hydrops at a given institution, the precise reasons for the more positive outcomes obtained in our study remain unclear. Moreover, there have been at least a dozen reported cases documenting resolution of fetal CCAMs with fluid noted in the pleural and/or abdominal cavities [2,[19][20][21][22][23][24][25]. Anecdotally, the administration of antenatal steroid therapy may also facilitate resolution of these lesions in the setting of hydrops [26].…”

Residual congenital cystic adenomatoid malformation and thoracic scar deformation after fetal surgery: a case report

“…Although resolution of hydrops is extremely rare, it has been reported either with [14][15][16][17] or without [7][8][9] medical therapy. Therefore, performing the operation in hydropic cases late in gestation (later than 28 weeks) may be unwarranted.…”

“…Expectant management is recommended if the size of the lesion is small and there are no signs of hydrops [3]. Once hydrops occurs, spontaneous resolution is extremely rare [7][8][9]. At that point fetuses are at high risk for demise [3,10,11]; thus, careful management is important.…”

Characteristics of congenital cystic adenomatoid malformations associated with nonimmune hydrops and outcome

“…perinatal mortality rates at tertiary institutions [1][2][3][4][5][6][7][8][9][10]. Despite rare reports of spontaneous resolution of hydrops in fetuses with CCAM, once hydrops has developed, reported survival rate is less than 10% [5,[10][11][12].…”

“…Despite rare reports of spontaneous resolution of hydrops in fetuses with CCAM, once hydrops has developed, reported survival rate is less than 10% [5,[10][11][12].…”