Prenatal diagnosis of lobar bronchial atresia

Maternal Fetal Medicine Unit, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand Cedex 1, France.
Ultrasound in Obstetrics and Gynecology (Impact Factor: 3.85). 01/2011; 37(1):110-2. DOI: 10.1002/uog.8838
Source: PubMed


We report three cases of fetal lobar bronchial atresia referred to our Fetal Medicine Center during the mid-trimester of pregnancy over the last 15 years. Lobar bronchial atresia can mimic a main stem bronchial atresia on mid-trimester ultrasound examination as it induces extensive lobar enlargement, major mediastinal shift and eversion of the diaphragm. It was associated with severe pulmonary hypoplasia in all three cases, even though polyhydramnios and ascites were absent in two. Termination of pregnancy was performed at parental request after extensive counseling in each of the cases and necropsy confirmed one or two enlarged lung lobes leading to major compression of the remaining lobe(s) of the ipsilateral lung, the contralateral lung and the heart. No other anomalies were observed and the karyotype was normal in all cases.

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Available from: Pierre Blanc, Oct 20, 2014
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    Ultrasound in Obstetrics and Gynecology 07/2011; 38(1):119-20. DOI:10.1002/uog.9054 · 3.85 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 07/2011; 38(1):119; author reply 119-20. DOI:10.1002/uog.9052 · 3.85 Impact Factor
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    ABSTRACT: Objective: To report the performance of fetal bronchoscopy in a case of pulmonary sequestration. Materials and Methods: A 24 year-old female, Gravida 2, Para 1, was referred at 27.5 weeks with a large fetal left lung mass with marked right mediastinal shift and no visible normal left lung. Differential diagnosis included possible bronchial atresia. Results: The patient underwent fetal laryngoscopy and fetal bronchoscopy at 31.5 weeks. The right lung and a portion of the left lung expanded during surgery as a result of bronchial lavage. Bronchial atresia or bronchogenic cyst were not found. Pregnancy continued uneventfully, with continuous growth of the right lung and a small amount of left lung. The patient delivered vaginally at term. The baby underwent thoracoscopic resection of a pulmonary sequestration at 10.5 months of age and did well. Conclusion: Fetal bronchoscopy is feasible. The procedure may prove useful in the differential diagnosis and in the potential treatment of different fetal lung lesions, as well as aid in the understanding of the role of bronchial obstruction as a common pathophysiologic mechanism for different fetal lung masses. Risks and benefits of fetal bronchoscopy warrant further experience.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 05/2012; 25(11):2354-8. DOI:10.3109/14767058.2012.695826 · 1.37 Impact Factor
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