title: Life-saving effects of fetal tracheal occlusion on pulmonary hypoplasia from preterm premature rupture of membranes.
abstract: BACKGROUND
  Preterm premature rupture of membranes before 22 weeks of gestation may result in severe fetal pulmonary hypoplasia. Fetoscopic tracheal balloon occlusion might result in catch-up pulmonary growth.
  
  
  METHODS
  After preterm premature rupture of membranes at 16 weeks of gestation, magnetic resonance imaging at 26 0/7 weeks showed a fetal lung volume of 13 mL and pulmonary blood flow hardly could be detected. Fetoscopic tracheal balloon occlusion was performed at 27 6/7 weeks; within 6 days, fetal lung volume increased to 70 mL and lung blood flow normalized. The fetus was delivered electively at 28 6/7 weeks. Six hours after delivery, the neonate required only 21% oxygen and was extubated after 55 hours.
  
  
  CONCLUSIONS
  Short-term fetoscopic tracheal balloon occlusion may result in rapid normalization of fetal lung volume and blood flow in fetuses with life-threatening pulmonary hypoplasia from preterm premature rupture of membranes before 22 weeks of gestation.
authors.affiliation: From the Department of Obstetrics and Prenatal Medicine-German Center for Fetal Surgery and Minimally-Invasive Therapy and the Departments of Radiology and Neonatology, University of Bonn, Bonn, Germany; and the Department of Cardiology, University Children's Hospital Münster, Münster, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kohl
authors.forename: Annegret
authors.initials: A
authors.lastname: Geipel
authors.forename: Kristina
authors.initials: K
authors.lastname: Tchatcheva
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Stressig
authors.forename: Winfried A
authors.initials: WA
authors.lastname: Willinek
authors.forename: Ulrich
authors.initials: U
authors.lastname: Gembruch
authors.forename: Andreas
authors.initials: A
authors.lastname: Müller
mesh_terms: D002585:Cesarean Section; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005325:Fetal Organ Maturity; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000098:blood supply / Q000196:embryology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D047928:Premature Birth; D014132:Trachea / Q000601:surgery*