[Cystic adenomatoid malformation of the lung at the fetal stage. Ultrasonographic diagnosis and counseling].
BACKGROUND
The aim of this study was to report the series of cystic malformation of the lung (CAML) detected at the Center for Prenatal Diagnosis of the University of Naples Federico II and compare the data with the current literature.


METHODS
In the period 1994-1997, ten cases of CAML have been detected at our unit. For each case, the following parameters were recorded: size of the cysts (according to the Stocker classification), side, presence of mediastinal shift, hydrops. For confirmation, necropsies and post natal files were sought.


RESULTS
CAML was type I in 3 cases, type II in 3, and type III in 4 cases. mediastinal shift was present in 7 cases, hydrops in 2 and bilateral renal agenesis in 1. Seven cases underwent termination of pregnancy, 2 are currently alive and thriving after surgery and one pregnancy is ongoing at 36 weeks of gestation. The diagnosis was straightforward in all cases, and there were no problems of differential diagnosis.


CONCLUSIONS
From an analysis of the data published in recent literature, it can be affirmed that hydrops but not mediastinal shift have negative prognostic significance. The abortion rate of 70% in our series, including 4 cases with a good prognosis, is somewhat frustrating. This figure underlines the need for a multidisciplinary counseling in which the pediatric surgeon, the psychologist and the sonographer may support the couple in overcoming the stress related to the acknowledgement of the lesion in order to reach the final decision about the outcome of the pregnancy.
Teodoro
A
A
Dipartimento di Ginecologia, Ostetricia e, Università degli Studi di Napoli, Federico II.
Lamberti
A
A
Liguori
M
M
Tartaglione
A
A
Tremolaterra
F
F
Paladini
D
D
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging; D000022:Abortion, Spontaneous; D003376:Counseling; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D016216:Ultrasonography, Prenatal