Life-saving effects of fetal tracheal occlusion on pulmonary hypoplasia from preterm premature rupture of membranes.
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.
Kohl
Thomas
T
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.
Geipel
Annegret
A
Tchatcheva
Kristina
K
Stressig
Rüdiger
R
Willinek
Winfried A
WA
Gembruch
Ulrich
U
Müller
Andreas
A
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*