title: Retrospective study of prenatal diagnosed pulmonary sequestration.
abstract: OBJECTIVE
  To describe the prenatal findings, treatments and outcomes of fetuses with pulmonary sequestrations (PS), which were retrospectively studied.
  
  
  METHODS
  From May 2010 to January 2013, 292 women were referred to the Guangdong Women and Children Hospital, Guangzhou because obstetric ultrasound had demonstrated fetal lung lesions. In 68 fetuses, the echogenic lung masses were pulmonary sequestrations deriving arterial blood supply from clearly identifiable systemic arteries rather than the pulmonary artery. We examined records of the 68 fetuses and measured the lesions and congenital cystic adenomatoid malformation volume ratio (CVR), provided prenatal counseling and treatment, documented the CVR, location of lesion, gestational age at diagnosis, need for fetal intervention, perinatal clinical course (including the development of hydrops, effusions, and neonatal respiratory distress), gestational age at delivery, postnatal ultrasound and CT, operation treatment, survival and pathology.
  
  
  RESULTS
  There were 68 PS in our study. All of 56 cases with CVR ≤ 1.6, survived without prenatal hydrops or postnatal respiratory symptoms. In 12 cases with CVR >1.6, 7 cases (58.3 %, 7/12) had hydrops, 10 cases (83.3 %, 10/12) survived, 2 cases (16.7 %, 2/12) of induced abortion, 8 cases (66 %, 8/12) were postnatal symptomatic. There was statistical significant difference in the incidence rate of hydrops and postnatal respiratory symptoms between the PS with CVR ≤ 1.6 and that with CVR >1.6. 66 cases postnatal survived, two cases of induced abortion. 64 cases had no prenatal treatment, two cases underwent thoracoamniotic shunt. The mean gestational age at birth was 38 weeks (range 34-40 weeks). 21 asymptomatic cases had no surgery. 45 cases (8 symptomatic and 37 asymptomatic) underwent surgical resections, 43 cases without postoperative complications, two cases of postoperative pneumothorax, no wound infection. Postoperative follow-up showed good growth in all surgery cases.
  
  
  CONCLUSIONS
  PS specific absence of hydrop was a congenital disorder with an excellent prognosis. CVR >1.6 was associated with fetal hydrops and postnatal symptoms. However, absolute CVR value cannot be used to select fetuses for fetal treatment before the development of hydrops. Surgery of PS in neonates or infants presented a good outcome.
authors.affiliation: Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Haichun
authors.initials: H
authors.lastname: Zhang
authors.forename: Junzhang
authors.initials: J
authors.lastname: Tian
authors.forename: Zhongping
authors.initials: Z
authors.lastname: Chen
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Ma
authors.forename: Gang
authors.initials: G
authors.lastname: Yu
authors.forename: Jiangyu
authors.initials: J
authors.lastname: Zhang
authors.forename: Guihua
authors.initials: G
authors.lastname: Jiang
authors.forename: Limin
authors.initials: L
authors.lastname: Wang
mesh_terms: D000028:Abortion, Induced; D001998:Bronchopulmonary Sequestration / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D002681:China; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000150:complications / Q000175:diagnosis; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006801:Humans; D015160:Hydrops Fetalis / Q000175:diagnosis; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods*