Successful ultrasound‐guided laser treatment of fetal hydrops caused by pulmonary sequestration

Microcystic or solid‐looking fetal lung lesions associated with hydrops are associated with a high mortality rate. The most common of these lesions are microcystic congenital cystic adenomatoid malformations and pulmonary sequestrations (PS). Performing open fetal surgery by hysterotomy and lobectom...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology 2007-04, Vol.29 (4), p.457-459
Main Authors: Oepkes, D., Devlieger, R., Lopriore, E., Klumper, F. J. C. M.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Bronchopulmonary Sequestration - complications
Bronchopulmonary Sequestration - diagnostic imaging
Diseases of mother, fetus and pregnancy
Female
fetal therapy
fetus
Gynecology. Andrology. Obstetrics
Humans
hydrops
Hydrops Fetalis - diagnostic imaging
Hydrops Fetalis - etiology
Hydrops Fetalis - surgery
laser
Laser Therapy - methods
lung tumor
Medical sciences
Pneumology
Pregnancy
Pregnancy Outcome
Pregnancy. Fetus. Placenta
pulmonary sequestration
Tumors of the respiratory system and mediastinum
Ultrasonography, Interventional
Ultrasonography, Prenatal
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Summary:Microcystic or solid‐looking fetal lung lesions associated with hydrops are associated with a high mortality rate. The most common of these lesions are microcystic congenital cystic adenomatoid malformations and pulmonary sequestrations (PS). Performing open fetal surgery by hysterotomy and lobectomy has, until now, been the only therapeutic option available following diagnosis of these lesions in the second trimester. Here we describe a new minimally invasive technique for the treatment of PS in the second trimester. Laser coagulation of the feeding systemic artery of the sequestration was performed under ultrasound guidance. The blood flow to the lung tumor was successfully arrested and hydrops reversed. The child was born at term and, at the time of writing, was alive and well at 2 years of age. Large PS with hydrops can be treated successfully by ultrasound‐guided minimally invasive laser surgery. It is therefore important to utilize color Doppler ultrasound imaging for identification of a systemic feeding blood vessel in solid fetal lung tumors. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.
ISSN:0960-7692
1469-0705
DOI:10.1002/uog.3984