Temporary fetoscopic tracheal balloon occlusion enhanced by hyperoncotic lung distension: is there a role in the treatment of fetal pulmonary hypoplasia from early preterm premature rupture of membranes?
OBJECTIVE
To assess the effect of fetoscopic tracheal occlusion (FETO) enhanced by hyperoncotic distension on pulmonary hypoplasia from preterm premature rupture of membranes prior to 22 weeks of gestation (ePPROM).


RESULTS
In a fetus with ePPROM since 19+5 weeks of gestation, MRI at 28+2 weeks provided a lung volume of 10 ml. FETO enhanced by hyperoncotic distension was performed at 28+3 weeks. After 4-5 days, balloon dislodgement was observed. The lung volume increased to 18 ml. The baby was born at 32+4 weeks and survived to discharge.


CONCLUSIONS
FETO enhanced by hyperoncotic distension may result in impressive lung distension in fetuses with pulmonary hypoplasia from ePPROM. Further research into the life saving potential of this strategy for this common and tragic gestational event is desired.
Kohl
Thomas
T
Department of Obstetrics and Prenatal Medicine, German Center for Fetal Surgery and Minimally Invasive Therapy, Bonn, Germany. thomas.kohl@ukb.uni-bonn.de
Müller
Andreas
A
Franz
Axel
A
Heep
Axel
A
Willinek
Winfried A
WA
Bartmann
Peter
P
Gembruch
Ulrich
U
D021721:Balloon Occlusion / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000628:therapy*; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis / Q000628:therapy*; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000648:ultrastructure; D008171:Lung Diseases / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D047928:Premature Birth / Q000000981:diagnostic imaging / Q000628:therapy; D014132:Trachea / Q000648:ultrastructure; D014463:Ultrasonography