title: Isolated unilateral pulmonary agenesis and other fetal thoracic anomalies.
abstract: OBJECTIVE
  Although the diagnostic workup and management regimens for many of the common fetal thoracic lesions have been well described, the understanding of pulmonary agenesis is more limited. A better understanding of the published reports of this condition is essential to provide proper care for these complicated pregnancies.
  
  
  OBJECTIVE
  The aims of this study were to provide a better understanding of the difficulties in the diagnosis and management of fetal thoracic lesions and to consolidate what is known about unilateral pulmonary agenesis.
  
  
  METHODS
  We performed a review of the English medical literature covering the last 20 years (1993-2013) in PubMed, MEDLINE, and MD Consult using search terms pulmonary agenesis, pulmonary aplasia, unilateral pulmonary agenesis, unilateral pulmonary aplasia, lung agenesis, lung aplasia, unilateral lung agenesis, and unilateral lung aplasia.
  
  
  RESULTS
  Prenatal diagnosis of pulmonary agenesis and other fetal thoracic lesions can be particularly challenging given that many anomalies have similar appearance on ultrasound. Fetal magnetic resonance imaging has been used in several of the reported cases to clarify the diagnosis. Once confirmed, there are several important prognostic factors to consider in the management of unilateral pulmonary agenesis. Poor prognostic factors include right-sided agenesis, the presence of genetic abnormalities, and other associated congenital anomalies.
  
  
  CONCLUSIONS
  Fetal magnetic resonance imaging can be a useful imaging modality when the diagnosis is unclear after ultrasound imaging. The management of cases with a poor prognosis should be guided by the nature of the associated anomalies. Cases of isolated pulmonary agenesis have an overall good prognosis and can be managed conservatively during pregnancy, with consideration of delivery at a tertiary care facility in case postnatal respiratory issues arise.
authors.affiliation: Medical Student, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Bronwyn C
authors.initials: BC
authors.lastname: Russell
authors.affiliation: Associate Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Paul
authors.initials: P
authors.lastname: Whitecar
authors.affiliation: Assistant Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Joshua F
authors.initials: JF
authors.lastname: Nitsche
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000002:abnormalities*; D008171:Lung Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011379:Prognosis; D016216:Ultrasonography, Prenatal