Heinrich Hanna, Linskens Ingeborg H, Gorter Ramon R, Oomen Matthijs W N, van Leeuwen Elisabeth, Pajkrt Eva
Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
Pediatr Surg Int. 2025 Jun 1;41(1):156. doi: 10.1007/s00383-025-06047-1.
The aim was to evaluate the prenatal course, postnatal outcome and diagnostic accuracy of fetuses with a prenatal diagnosis of isolated congenital lung anomalies (iCLA).
A retrospective cohort is described from the Amsterdam UMC between January 2007 and January 2022. The CPAM volume ratio (CVR) was calculated. The concordance between prenatal diagnosis and lesion progression was compared to postnatal findings. Postnatal surgical interventions were reported.
This study includes 113 prenatal cases of iCLA. Ten percent (10/100 cases with available CVR) progressed into high-risk lesions (CVR > 1.6), with a negative impact on survival. In total, 108 (95.6%) cases resulted in live birth. Acute respiratory distress was observed in 6.5% (7/108). During postnatal follow-up, the lesion was still detectable in 10/15 (66.7%) cases in which complete regression was seen prenatally. Fifty percent (54/108) of the live-born children required surgical management.
iCLA has a favorable prognosis in pregnancy, however, close prenatal monitoring is advised. Future parents should be informed about the importance of postnatal follow-up since lesions are often persistent even if prenatal scans may no longer have visualized them, as well as the chance of developing respiratory distress and the probability of undergoing surgery.
目的是评估产前诊断为孤立性先天性肺异常(iCLA)的胎儿的产前病程、产后结局及诊断准确性。
描述了2007年1月至2022年1月期间阿姆斯特丹大学医学中心的一项回顾性队列研究。计算了先天性肺气道畸形体积比(CVR)。将产前诊断与病变进展之间的一致性与产后结果进行比较。报告了产后手术干预情况。
本研究纳入113例产前诊断为iCLA的病例。10%(100例有可用CVR的病例中的10例)进展为高危病变(CVR>1.6),对生存有负面影响。总共108例(95.6%)病例活产。6.5%(108例中的7例)观察到急性呼吸窘迫。在产后随访中,产前可见完全消退的15例病例中有10例(66.7%)仍可检测到病变。50%(108例中的54例)活产儿童需要手术治疗。
iCLA在孕期预后良好,然而,建议进行密切的产前监测。应告知准父母产后随访的重要性,因为即使产前扫描可能不再显示病变,病变通常仍会持续存在,以及发生呼吸窘迫的可能性和接受手术的概率。