Accuracy of prenatal diagnosis of congenital cystic adenomatoid malformation.

A series of 13 consecutive patients with a prenatal diagnosis of congenital cystic adenomatoid malformation (CCAM) were reviewed with respect to prenatal ultrasound findings, clinical features at birth, and postnatal outcome. In two cases (15%) the abnormality regressed in utero. Only three infants (23%) showed any respiratory distress at birth. After a mean of 25 months postnatal follow up, 11 patients (85%) were found to have a definite pulmonary abnormality. In seven patients (54%) the specific prenatal diagnosis of CCAM has been confirmed (five histologically, two radiologically). Four infants (31%) were found to have other types of pulmonary abnormality and in two (15%) the lungs remain apparently normal. Prenatal ultrasound appears reliable in the detection of pulmonary abnormalities but the variety of conditions identified postnatally suggests that specific prenatal diagnoses and prognoses should be avoided; prenatal counselling and perinatal management should be adapted accordingly.