AI Summary & Key Takeaways
AI InsightMore than half of the CPAM lesions regressed spontaneously with expectant management.
📌 3 Key Takeaways
Abstract
Aims: This study planned to evaluate fetal non-cardiac thoracic anomalies, which are less common than other organ systems, in terms of diagnosis, incidence, therapy and prognosis. Methods: The data of 66 cases who were evaluated in a perinatology department between January 2021 and July 2023 with diagnosis of fetal non-cardiac thoracic abnormalities were analyzed retrospectively. Results: A total of 66 cases were in our study with a mean maternal age of 28.61±4.9 years and a median gestational week of first assessment at our center of 24 weeks (15-38 weeks). The most common non-cardiac thoracic malformation was congenital diaphragmatic hernia (30 cases, 45.4%), followed by congenital pulmonary airway malformation (CPAM) (17 cases, 25.7%). Termination of pregnancy was performed in 4 cases (6.06%). While genetic testing was carried out in a total of 9 cases (13.9%), no chromosomal abnormality was found in any of these cases. In utero interventional procedure was performed in 5 cases (7.57%) and success was achieved in 3 cases. Ten (58.8%) cases with CPAM lesions were resolved during the late antenatal or postnatal period with expectant management. Surgery was performed in 2 (11.8%) of 17 cases with CPAM. Conclusion: Deliveries of the FNTA cases should be planned in tertiary centers where necessary intervention and care can be provided. A multi-disciplinary team could demonstrate a crucial role in assuring that the pregnant woman and fetus obtain appropriate treatment and are managed during the antenatal and postnatal periods. US plays a crucial role in the diagnosis and management of FNTA cases during the prenatal period rather than fetal MRI and other diagnostic tools. More than half of the CPAM lesions regressed spontaneously with expectant management.
Özet
Amaç Çalışmamızda diğer organ sistemlerine göre daha az görülen fetal kalp dışı toraks anomalilerini tanı, insidans, tedavi ve prognoz açısından değerlendirmeyi planladık. Yöntem Ocak 2021-Temmuz 2023 tarihleri arasında perinatoloji bölümünde fetal kalp dışı torasik anormallik tanısıyla değerlendirilen 66 olgunun verileri retrospektif olarak incelendi. Sonuçlar Çalışmamızda ortalama anne yaşı 28,61±4,9 ve ortalama gebelik haftası 24,5 (en az 15-en çok 38) olan toplam 66 olgu yer aldı. En sık görülen kalp dışı torasik malformasyon konjenital diyafragma hernisi (30 vaka, %45,4) olup bunu konjenital pulmoner hava yolu malformasyonu (CPAM) (17 vaka, %25,7) ve özofagus atrezisi (6 vaka, %9) takip etti. Olguların 4'ünde (%6,06) gebelik sonlandırıldı, toplam 9 olguda (%13,9) genetik araştırma yapılırken, bu olguların hiçbirinde genetik anormal genetik analize rastlanmadı. Beş olguya (%7,57) in utero girişimsel işlem uygulandı ve 3 olguda başarı sağlandı. Çözüm: Diğer organ sistemlerine göre daha az sıklıkta gördüğümüz toraks anomalilerinin görülme sıklığı yıllar içinde pek değişmese de tedavi yaklaşımları ve doğum sonrası prognoz yıllar geçtikçe iyileşmektedir. Yeni tedavi yaklaşımlarından bazılarını kullandık ve iyi sonuçlar aldık.