Abstract
Background: Non-immune hydrops (NIH) associated with bronchopulmonary sequestration (BPS) is quite rare with a 95% risk of intrauterine fetal death, without a fetal intervention. Case Presentation: We describe a case of an antenatally diagnosed extralobar BPS with severe NIH, who underwent fetal thoracentesis, but had worsening of NIH requiring an emergency cesarean section. Postnatally, the baby required skillful intensive care management and timely surgical management in the form of a sequestrectomy. Conclusion: We report the smallest neonate with antenatally diagnosed NIH complicating BPS treated successfully by early neonatal surgery.
Highlights
Bronchopulmonary sequestration (BPS) is a congenital lung anomaly that consists of a discrete mass of lung tissue that does not communicate with the tracheobronchial tree and receives its blood supply from the systemic circulation
Most bronchopulmonary sequestration (BPS) regress in-utero, though a large BPS may be associated with mediastinal shift causing complications like polyhydramnios, cardiac failure, and Non-immune hydrops (NIH).[2]
The ultrasound showed refilling of the left-sided pleural effusion, worsening hydrops, and progressive cardiac failure, which prompted a decision for an emergency cesarean section rather than further fetal interventions
Summary
Bronchopulmonary sequestration (BPS) is a congenital lung anomaly that consists of a discrete mass of lung tissue that does not communicate with the tracheobronchial tree and receives its blood supply from the systemic circulation. There was gross left-sided pleural effusion with mediastinal shift causing pseudodextrocardia and ascites with hydrops. The ultrasound showed refilling of the left-sided pleural effusion, worsening hydrops, and progressive cardiac failure, which prompted a decision for an emergency cesarean section rather than further fetal interventions.
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