Outcome predictors for infants with cystic lung disease.
OBJECTIVE
This study aimed at identifying characteristic features indicating congenital cystic adenomatoid malformation of the lung (CCAM) and evaluating the outcome predictors to identify prenatally subgroups of fetuses with significantly different probabilities of mortality or severe respiratory difficulty.


METHODS
Twenty-eight neonates who had undergone antenatal evaluation for cystic lung disease (CLD) were reviewed retrospectively. The patients were divided into 3 groups according to the severity of their clinical course; mild (n = 7), moderate (n = 13), and severe (n = 8). Ultrasonographic findings in the fetus and their pulmonary lesion were evaluated. The normal lung to thorax transverse area ratio (L/T) was measured by ultrasonography.


RESULTS
High echogenicity of the lesion throughout pregnancy and polyhydramnios were frequently seen in CCAM. All of the patients with other CLD showed isoechogenicity at the end of pregnancy. All patients in the severe group had both polyhydramnios and fetal hydrops. L/T was increased in mild and moderate groups, whereas no patient in the severe group had an increase in L/T at the final measurement. Each value of final L/T in the severe group was less than 0.25.


CONCLUSIONS
The subgroup of fetuses with an increased probability of mortality or severe respiratory difficulty could be predicted from the combination of polyhydramnios, fetal hydrops, and a final L/T value of less than 0.25.
Usui
Noriaki
N
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Kamata
Shinkichi
S
Sawai
Toshio
T
Kamiyama
Masafumi
M
Okuyama
Hiroomi
H
Kubota
Akio
A
Okada
Akira
A
D001980:Bronchi / Q000002:abnormalities; D001994:Bronchogenic Cyst / Q000000981:diagnostic imaging / Q000196:embryology / Q000453:epidemiology; D001998:Bronchopulmonary Sequestration / Q000000981:diagnostic imaging / Q000196:embryology / Q000453:epidemiology; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging / Q000196:embryology / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008168:Lung / Q000000981:diagnostic imaging / Q000196:embryology; D008297:Male; D006831:Polyhydramnios / Q000209:etiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D012120:Respiration Disorders / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013909:Thorax / Q000000981:diagnostic imaging / Q000196:embryology; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal