title: [Fetal therapy--evaluation of intrauterine therapy in congenital cystic adenomatoid malformation of the lung (CCAM)].
abstract: OBJECTIVE
  The aim of the study was to evaluate the efficiency of intrauterine treatment of large cysts in fetal lungs using thoracoamniotic shunts.
  
  
  METHODS
  Our observational retrospective study was carried out on a series of 8 fetuses who under went thoracoamniotic shunting after sonographic statement of large macrocystic lesions in the lungs at the Department of Gynecology Fertility and Therapy of the Fetus, Polish Mother's Research Institute, between 2009-2014.
  
  
  RESULTS
  Mean gestational age at shunt insertion was 26.6 (range 18-33) weeks. Marked mediastinal shift in the echocardiographic examination was observed in all of the investigated cases. Five fetuses had polyhydramion, with 4 hydropic cases. Out of the remaining 4 fetuses without impaired cardiac function, 3 had very large lesions at initial presentation and 1 had a lesion that was rapidly increasing in size. Shunt insertion was successful in all cases. Only one patient went into premature labor (at 36 weeks of gestation). Mean gestational age at delivery was 38.2 weeks. Cesarean section was necessary in the half of the patients due to obstetric complications. All newborns underwent resection of the lesions. Three of them were operated in the first month after birth. The rest of the operations were postponed. Prenatal diagnosis of congenital cystic adenomatoid malformations was confirmed by pathologists in all cases.
  
  
  CONCLUSIONS
  Intrauterine therapy of macrocystic lesions in fetal lungs enables to achieve good perinatal outcome It needs to be considered in every case of a fetus with developing impaired cardiac function.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Szaflik
authors.forename: Magdalena
authors.initials: M
authors.lastname: Litwińska
authors.forename: Przemysław
authors.initials: P
authors.lastname: Oszukowski
authors.forename: Anna
authors.initials: A
authors.lastname: Piaseczna-Piotrowska
authors.forename: Ewelina
authors.initials: E
authors.lastname: Litwińska
authors.forename: Waldemar
authors.initials: W
authors.lastname: Krzeszowski
authors.forename: Ewa
authors.initials: E
authors.lastname: Gulczyńska
authors.forename: Iwona
authors.initials: I
authors.lastname: Maroszyńkas
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Janiak
mesh_terms: D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology / Q000601:surgery*; D005260:Female; D046128:Fetal Therapies / Q000379:methods*; D005332:Fetoscopy / Q000379:methods; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D013907:Thoracostomy / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*