Gowda Mamatha, Gupta Shilpa, Ali Ashraf, Paranthaman Shanthi
Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
J Ultrasound Med. 2017 Oct;36(10):2179-2185. doi: 10.1002/jum.14273. Epub 2017 Jun 6.
Described here are a series of four cases of congenital high airway obstruction in the fetus. All of the patients presented in the second trimester and all had hydrops fetalis. Three cases had bilateral hyperinflated lungs, midline shift of heart, flattening or inversion of the diaphragm, and fetal ascites. Autopsy was performed in one of these three and showed laryngeal atresia. In one fetus, there was only a unilateral huge enlargement of the lung with mediastinal shift. On autopsy, this fetus had atresia of right main bronchus. All parents had terminated the pregnancy following the prenatal diagnosis. Laryngeal atresia is an extremely rare fetal anomaly with dismal prognosis. It is important to differentiate the condition from other lesions with a more favorable prognosis, such as congenital adenomatoid malformation of the lung. Much research is needed in the future to explore the therapeutic options, including fetoscopic intervention or transplantation of stem cell-derived airways.
本文描述了一系列四例胎儿先天性高位气道梗阻病例。所有患者均在孕中期就诊，且均有胎儿水肿。三例患者有双侧肺过度膨胀、心脏中线移位、膈肌扁平或倒置以及胎儿腹水。这三例中的一例进行了尸检，显示为喉闭锁。在一例胎儿中，仅一侧肺出现巨大肿大并伴有纵隔移位。尸检发现该胎儿右主支气管闭锁。所有父母在产前诊断后均终止了妊娠。喉闭锁是一种极其罕见的胎儿异常，预后不良。将这种情况与其他预后较好的病变（如先天性肺腺瘤样畸形）区分开来很重要。未来需要进行大量研究以探索治疗方案，包括胎儿镜干预或干细胞衍生气道移植。
