title: [Performance of prenatal diagnosis and postnatal development of congenital lung malformations].
abstract: OBJECTIVE
  For many diseases, the comparison of prenatal diagnosis with a histopathological reality is not always possible. Fetal lung pathology, with its high rate of surgery in postnatal, allows this assessment. This study proposes an approach to the reliability of prenatal diagnosis and analysis of the postnatal development of all children in care for congenital pulmonary malformation (CPM).
  
  
  METHODS
  This is a retrospective study of all cases of CPM diagnosed in Poitiers University Hospital from 1995 to 2011. Cases diagnosed prenatally were identified and the diagnostic accuracy was studied by histology when cases had surgery. The postnatal development of prenatally diagnosed cases is described and compared to children who did not receive prenatal diagnosis.
  
  
  RESULTS
  Among the 45 cases of CPM supported at the Poitiers University Hospital, 30 had received prenatal diagnosis of isolated CPM. The diagnostic concordance between antenatal ultrasound and the final diagnosis is κ=0.67 (CI95% [0.38 to 0.94]). The sensitivity of ultrasound was 90% (CI95% [55-99.7]) in our series for the diagnosis of CAMP (cystic adenomatoid malformation pulmonary). We found a sonographic disappearance of lesions in 4 children, 1 child in regression, stable lesions in 21 cases. Four children showed an increase in volume of the malformation, with signs of poor tolerance in 3 cases. After birth, children who received a prenatal diagnosis were no more symptomatic than those whose diagnosis was made postnatal: 21 (70%) versus 11 (73%; P=1) respectively. Similarly, they often received prophylactic surgery: 18 (60%) versus 2 (13%) respectively (P<0.01) and less often suffered post-surgery complication: 3 (10%) versus 10 (67%) respectively (P<0.01). The number of children monitored was not significantly different in the two groups.
  
  
  CONCLUSIONS
  Prenatal diagnosis allows for the precise nature of the lesion in 90% of cases in 2013 and had no impact on symptomatology at birth. When prenatal diagnosis is possible, preventive surgery probably reduces the occurrence of emergency surgery.
authors: CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Université de Poitiers, 15, rue de l'Hôtel-Dieu, TSA 71117, 86073 Poitiers cedex 9, France; Centre pluridisciplinaire de diagnostic prénatal, CHU de Poitiers, 86000 Poitiers, France. Electronic address: david.desseauve@univ-poitiers.fr.
authors: D
authors: D
authors: Desseauve
authors: CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Centre pluridisciplinaire de diagnostic prénatal, CHU de Poitiers, 86000 Poitiers, France.
authors: M
authors: M
authors: Dugué-Marechaud
authors: CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Service de chirurgie pédiatrique, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France.
authors: S
authors: S
authors: Maurin
authors: CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Service de chirurgie pédiatrique, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France.
authors: M-È
authors: MÈ
authors: Gatibelza
authors: CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Centre pluridisciplinaire de diagnostic prénatal, CHU de Poitiers, 86000 Poitiers, France.
authors: V
authors: V
authors: Vequeau-Goua
authors: CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Service de radiologie, CHU de Poitiers, 86000 Poitiers, France.
authors: M
authors: M
authors: Mergy-Laurent
authors: CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Université de Poitiers, 15, rue de l'Hôtel-Dieu, TSA 71117, 86073 Poitiers cedex 9, France; Service de chirurgie pédiatrique, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France.
authors: G
authors: G
authors: Levard
authors: CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Université de Poitiers, 15, rue de l'Hôtel-Dieu, TSA 71117, 86073 Poitiers cedex 9, France; Centre pluridisciplinaire de diagnostic prénatal, CHU de Poitiers, 86000 Poitiers, France.
authors: F
authors: F
authors: Pierre
mesh_terms: D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
keywords: Congenital; Congénital; Diagnosis; Diagnostic; Echography; Lung; Malformation; Performance; Poumon; Échographie