OC25.05: Percutaneous laser ablation under ultrasound guidance for fetal hyperechogenic microcystic lung lesions with hydrops

Abstract

Objectives: To determine the perinatal outcome of fetuses with congenital cystic lung lesions complicated by hydrops, who underwent thoracoamniotic shunting. Methods: A retrospective study of 7 hydropic fetuses with prenatally diagnosed congenital cystic lung malformation (4) or bronchopulmonary sequestration (3), who underwent thoracoamniotic shunting at a single tertiary center. Results: The median gestational age at diagnosis was 23 weeks (15–29) and the median gestational age at shunt insertion was 25 weeks (19–31). In 6 cases, the hydrops resolved following shunt insertion, whereas in one fetus, who underwent shunting at 19 weeks, the hydrops persisted despite the shunting and the patient elected to terminate the pregnancy. All 6 fetuses whose hydrops resolved following shunting were born alive at a median gestational age of 36.5 weeks (33–38) resulting in perinatal survival of 86%. None of the patients delivered prior to 32 weeks of gestation. Conclusions: Hydropic fetuses with congenital cystic lung lesions can benefit from thoraco-amniotic shunting resulting in perinatal survival of 86%. Therefore, hydropic fetuses with macrocystic CCAM or BPS should be offered thoraco-amniotic shunting as the treatment of choice.