Postnatal Chest Wall Deformities after Fetal Thoracoamniotic Shunting for Congenital Cystic Adenomatoid MalformationMerchant A.M. · Peranteau W. · Wilson R.D. · Johnson M.P. · Bebbington M.W. · Hedrick H.L. · Flake A.W. · Adzick N.S.
Center for Fetal Diagnosis and Treatment, Children’s Hospital of Philadelphia, and Departments of Surgery and Obstetrics/Gynecology, University of Pennsylvania, Philadelphia, Pa., USA
Objectives: Large macrocystic congenital cystic adenomatoid malformations (CCAMs) can be treated with thoracoamniotic (TA) shunting to reduce CCAM volume. Two CCAM fetuses treated with TA shunt had postnatal radiographic rib deformities. Study Design: Retrospective review of prenatal TA shunting for large macrocystic CCAMs evaluated for the presence of rib deformities. Comparison groups not eligible for TA shunting included nonshunted CCAMs resected postnatally (group A) and size-matched nonshunted CCAMs resected postnatally (group B). Results: Chest wall abnormalities were identified in 77% of newborns ranging from severe concavity and fractures (in two fetuses shunted at 18 and 20 weeks of gestation) to rib thinning compared to comparison groups A and B. The severity of chest wall deformity correlated with earlier gestational age at shunting. Conclusions: TA shunting at less than 21 weeks of gestational age may result in postnatal chest wall deformity. This observation should be discussed during counseling for this procedure.
© 2007 S. Karger AG, Basel
Received: July 24, 2006
Accepted after revision: August 28, 2006
Published online: July 24, 2007
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 3, Number of References : 12
Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)
Vol. 22, No. 6, Year 2007 (Cover Date: October 2007)
Journal Editor: Holzgreve, W. (Basel)
ISSN: 1015–3837 (print), 1421–9964 (Online)
For additional information: http://www.karger.com/FDT