Vrecenak Jesse D, Howell Lori J, Khalek Nahla, Moldenhauer Julie S, Johnson Mark Paul, Coleman Beverly G, Victoria Teresa, Hedrick Holly L, Peranteau William H, Flake Alan W, Adzick N Scott
Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia Pa., USA.
Fetal Diagn Ther. 2014;36(4):312-9. doi: 10.1159/000358325. Epub 2014 Nov 5.
The outcomes of prenatally diagnosed lung lesions in the context of multigestational pregnancies are unknown.
Of 960 fetal lung lesion cases evaluated at a single tertiary center over 16 years, 30 occurred in multigestational pregnancies. We reviewed this series to aid in prenatal counseling of affected families and to provide prognostic information for decision making. Pre- and postnatal clinical characteristics were gathered for these pregnancies, and the morbidity and mortality were determined for both affected and normal fetuses, whether twins or triplets.
Mortality was found to be 3/30 (10%) for affected fetuses, and morbidity in normal co-twins was consistent with the degree of prematurity. No morbidity was seen in co-twins born at or after 36 weeks of gestation. Median gestational age at delivery was 35 5/7 weeks.
Outcomes for the affected fetus correlate with the size and pathophysiologic consequences of the lesion and are not worse than previously reported outcomes for similar lesions in singleton pregnancies, while morbidity in the normal co-twin is consistent with prematurity related to the fetal age of the multiple gestation at delivery, irrespective of the fetal lung lesion.
