Fetal Thoracoamniotic Shunting in a Case of Congenital Pulmonary Airway Malformations with Hydrops Fetalis

Hayase Nitta; Yusuke Taira; Tadatsugu Kinjo; Yukiko Chinen; Hitoshi Masamoto; Naoya Sanabe; Hideki Goya; Tomohide Yoshida; Rika Sugibayashi; Masahiro Sumie; Seiji Wada; Haruhiko Sago; Yoichi Aoki

doi:10.1055/s-0037-1606830

American Journal of Perinatology Reports, Inhaltsverzeichnis

CC-BY-NC-ND 4.0 · AJP Rep 2017; 07(03): e185-e187
DOI: 10.1055/s-0037-1606830

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fetal Thoracoamniotic Shunting in a Case of Congenital Pulmonary Airway Malformations with Hydrops Fetalis

Autor*innen

Hayase Nitta

¹Department of Obstetrics and Gynecology, University of the Ryukyus, Okinawa, Japan
Yusuke Taira

¹Department of Obstetrics and Gynecology, University of the Ryukyus, Okinawa, Japan
Tadatsugu Kinjo

¹Department of Obstetrics and Gynecology, University of the Ryukyus, Okinawa, Japan
Yukiko Chinen

¹Department of Obstetrics and Gynecology, University of the Ryukyus, Okinawa, Japan
Hitoshi Masamoto

¹Department of Obstetrics and Gynecology, University of the Ryukyus, Okinawa, Japan
Naoya Sanabe

²Department of Digestive and General Surgery, University of the Ryukyus, Okinawa, Japan
Hideki Goya

³Department of Pediatrics, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
Tomohide Yoshida

³Department of Pediatrics, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
Rika Sugibayashi

⁴Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
Masahiro Sumie

⁴Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan

⁵Department of Obstetrics, Fukuoka Children's Hospital, Fukuoka, Japan
Seiji Wada

⁴Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
Haruhiko Sago

⁴Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
Yoichi Aoki

¹Department of Obstetrics and Gynecology, University of the Ryukyus, Okinawa, Japan

Abstract

Aim We report a case of congenital pulmonary airway malformation (CPAM) with hydrops in which the fetus underwent thoracoamniotic shunting.

Case Report A 40-year-old (G1P1) woman was diagnosed with a macrocystic CPAM. Thoracoamniotic shunting was performed at 19 weeks of gestation but not well drained and was successfully performed again at 23 weeks. However, the CPAM volume ratio, abdominal circumference, and amniotic fluid index started increasing from 28 weeks and hydrops worsened. The insufficient shunting and the fetal cardiac failure had to be considered. At 32 weeks, a male infant with general edema and massive ascites was born weighing 3,362 g (+4.79 SD) with Apgar scores of 2 and 4. The infant was intubated and high-frequency oscillation and nitric oxide therapies were instituted. The resection of CPAM was performed on day 2. Nasal continuous positive airway pressure was instituted on day 16. The infant was discharged and prescribed with home oxygen therapy (HOT) on day 65. The infant was able to leave the HOT at 30 months and is currently 34 months of age in good condition.

Conclusion Fetal thoracoamniotic shunting may be life-saving in CPAM complicated by hydrops and that this treatment might be sufficient to cure the child.

Keywords

CPAM - thoracoamniotic shunting - hydrops fetalis - high-frequency oscillation - nitric oxide

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Referenzen

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