Congenital cystic adenomatoid malformation: monitoring the antenatal and short-term neonatal outcome.
OBJECTIVE
To determine the antenatal and short-term neonatal outcome of antenatally detected congenital cystic adenomatoid malformation (CCAM).


METHODS
A retrospective review was conducted on all women with an antenatal diagnosis of CCAM who attended the Royal Women's Hospital, Melbourne, between January 1995 and December 2005.


RESULTS
An antenatal diagnosis of CCAM was made in 38 singleton pregnancies. Serial ultrasounds were performed in 34 cases. Thirteen lesions (38%) appeared to resolve, ten lesions (29%) appeared to decrease, four lesions (12%) appeared to remain unchanged and seven lesions (21%) appeared to increase in size. Four pregnancies (10.5%) were complicated by hydrops fetalis which was associated with a poor outcome. Thirty-seven babies were liveborn. Seven babies (18.9%) developed respiratory distress. Two of these babies died within two days of birth resulting in three deaths in total. Two babies were lost to follow up (n=33). Sixty per cent of babies in whom the CCAM appeared to resolve on antenatal ultrasound had an abnormal chest X-ray (CXR). All computed tomography (CT) scans (eight of eight) in this group were abnormal. Of the surviving babies, 27.3% (nine of 33) have had surgery to date.


CONCLUSIONS
The antenatal diagnosis of CCAM is associated with a good short-term prognosis. The pregnancy should initially be managed at a tertiary centre with serial ultrasound. Asymptomatic babies should have a postnatal CT even if the CCAM appears to have resolved or decreased on antenatal ultrasound.
Tran
Hong
H
Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Carlton, Victoria, Australia. hong.tran@rwh.org.au
Fink
Michelle A
MA
Crameri
Joe
J
Cullinane
Fiona
F
D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015160:Hydrops Fetalis / Q000175:diagnosis / Q000401:mortality / Q000473:pathology; D007226:Infant Mortality; D007231:Infant, Newborn; D008168:Lung / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D011379:Prognosis; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016216:Ultrasonography, Prenatal; D014739:Victoria