In-utero treatment of prenatal thoracic abnormalities by thoraco-amniotic shunts, short and long term neuro developmental outcome: A single center experience.
J Pediatr Surg
; 57(3): 364-368, 2022 Mar.
Article
en En
| MEDLINE
| ID: mdl-34588133
ABSTRACT
BACKGROUND:
Severe primary fetal hydrothorax (PFH) and fetal lung lesions (FLL) such as congenital pulmonary airway malformation (CPAM) and Bronchopulmonary sequestration (BPS) are often treated by thoraco-amniotic shunt (TAS).OBJECTIVES:
To compare short and long-term outcome of fetuses treated by TAS due to FLL to those treated due to PFH.METHOD:
A retrospective analysis was performed for all fetuses treated by TAS, between the years 2004-2015, evaluating the short and long term neurodevelopmental outcome. Long term neurodevelopment was additionally analyzed prospectively by Vineland adaptive behavioral scale (VABS) standardized questionnaires.RESULTS:
38 fetuses were treated by 52 TAS insertions; of which 13 (35%) due to FLL and 25 due to PFH. Perinatal survival was high (87.9%) with 3 neonatal death and one termination of pregnancy (TOP). High survival rate persisted even in cases requiring recurrent shunt insertion (80% survival). There was no significant difference in short or long term outcome including perinatal survival (84% Vs 90%, P = 0.64) and hydrops resolution (91% Vs 63%, p = 0.19). Long term outcome, including rate of neurodevelopmental abnormalities (23.5% Vs 20%) and VABS score (91.3 ± 13.3 Vs 96.4 ± 14.7), were similar for both groups.CONCLUSION:
TAS insertion is effective and resulting in high perinatal survival even in cases when sequential insertion is needed. Short and long- term outcome of neonates with FLL treated by TAS are comparable to neonates treated due to PFH.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Malformación Adenomatoide Quística Congénita del Pulmón
/
Secuestro Broncopulmonar
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
Límite:
Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Revista:
J Pediatr Surg
Año:
2022
Tipo del documento:
Article
País de afiliación:
Israel