title: Fetal lung lesions: can we start to breathe easier?
abstract: OBJECTIVE
  The purpose of this study was to develop a simple and accurate approach for risk stratification of fetal lung lesions that are associated with respiratory compromise at birth.
  
  
  METHODS
  We conducted a retrospective review of 64 prenatal lung lesions that were managed at a single fetal care referral center (2001-2011). Sonographic data were analyzed and correlated with perinatal outcomes.
  
  
  RESULTS
  Hydrops occurred in only 4 cases (6.3%). Among fetuses without hydrops, the congenital pulmonary airway malformation volume ratio (CVR) was the only variable that was associated significantly with respiratory compromise and the need for lung resection at birth (P < .01). Based on a maximum CVR >1.0, the sensitivity, specificity, positive predictive value, and negative predictive value for respiratory morbidity were 90%, 93%, 75%, and 98%, respectively.
  
  
  CONCLUSIONS
  Nonhydropic fetuses with a maximum CVR >1.0 are a subgroup of patients who are at increased risk for respiratory morbidity and the need for surgical intervention. These patients should be delivered at a tertiary care center with pediatric surgery expertise to ensure optimal clinical outcomes.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, C. S. Mott Children's Hospital and Von Voigtlander Women's Hospital, University of Michigan Health System, Ann Arbor, MI 48109, USA.
authors.forename: Stacey
authors.initials: S
authors.lastname: Ehrenberg-Buchner
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Stapf
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Berman
authors.forename: Robert A
authors.initials: RA
authors.lastname: Drongowski
authors.forename: George B
authors.initials: GB
authors.lastname: Mychaliska
authors.forename: Marjorie C
authors.initials: MC
authors.lastname: Treadwell
authors.forename: Shaun M
authors.initials: SM
authors.lastname: Kunisaki
mesh_terms: D001998:Bronchopulmonary Sequestration / Q000150:complications / Q000000981:diagnostic imaging*; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000592:standards*