Bilateral pulmonary agenesis diagnosed in the 13 th week of gestation - a case report and literature review

B Kuanova,M Terzic,N Arsenovic,S Terzic,T Mihailovic

doi:10.12891/ceog4663.2019

Abstract

Bilateral pulmonary agenesis (BPA) is a rare congenital lung malformation incompatible with extra-uterine life, diagnosed by various prenatal imaging modalities in the second and third trimesters. Essentials for diagnosis are complete absence of lungs and bronchi and no pulmonary vascular supply. In the present case, both convex and vaginal ultrasound scan performed at 13th GW revealed an anechoic content in the entire fetal thorax with no evidence of pericardial effusion, fetal heart diseases, or any other accompanying congenital malformations. On three-vessel view (3VV), bifurcation of pulmonary artery could not be identified, which confirmed the diagnosis of BPA. In conclusion, clinical importance of combining the up-to-date technological tools and clinical expertise in establishing the diagnosis as early as in the first trimester allows the clinicians to terminate the pregnancy with the lowest incidence rate of eventual complications related to the procedure. According to the literature data, this is the first and therefore unique case of BPA diagnosed in the 13th week of gestation.

Highlights

The aim of this report is to present the case of Bilateral pulmonary agenesis (BPA) diagnosed as early as in the 13th week of gestation, representing the unique case report diagnosed at this gestational age
Double test was normal, anechoic content was present in the entire thorax (Figure 1a). This finding was interpreted as pericardial effusion and accompanied by a precisely undefined – suspected congenital heart disease
As BPA is incompatible with extrauterine life, there is a need to make a reliable diagnosis in pregnancy at the earliest

Summary

Introduction

Congenital lung malformations can be identified in the immediate birth period or in early childhood; they can be diagnosed incidentally on routine imaging or autopsy [1]. The aim of this report is to present the case of BPA diagnosed as early as in the 13th week of gestation, representing the unique case report diagnosed at this gestational age. Double test was normal, anechoic content was present in the entire thorax (Figure 1a). This finding was interpreted as pericardial effusion and accompanied by a precisely undefined – suspected congenital heart disease. Due to this sonographic finding, the patient was referred to this Clinic for an expert exam

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Discussion

Conclusion