Outcome of antenatally diagnosed cystic adenomatoid malformations.
OBJECTIVE
Twenty-two cases of antenatally diagnosed congenital cystic adenomatoid malformations are reported.


METHODS
Case management is reviewed.


RESULTS
Eighteen women continued pregnancy after diagnosis. In nine cases nonimmune hydrops fetalis did not develop and all infants survived. Nonimmune hydrops fetalis developed in the other nine; fetal intervention was performed in eight cases. In the single case of nonimmune hydrops fetalis without intervention, the neonate died. In four cases aspiration of macrocystic lesions was performed. In two cases cystoamniotic shunts were placed. Neither aspiration or shunting provided long-term benefit. In six cases fetal lobectomy was ultimately performed and four survived. Two fetuses did not undergo in utero surgery; one was delivered prematurely after cyst aspiration and lived, and the other previable fetus was delivered soon after shunting.


CONCLUSIONS
Fetal survival is best related to development of nonimmune hydrops fetalis. Aspiration of cystic lesions and cystoamniotic shunts generally provide short-term benefit. Early experience with fetal surgery for congenital cystic adenomatoid malformations has been encouraging.
Kuller
J A
JA
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco.
Yankowitz
J
J
Goldberg
J D
JD
Harrison
M R
MR
Adzick
N S
NS
Filly
R A
RA
Callen
P W
PW
Golbus
M S
MS
D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging* / Q000628:therapy; D004322:Drainage; D005260:Female; D005333:Fetus / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012008:Recurrence; D016216:Ultrasonography, Prenatal