Temporary fetoscopic tracheal balloon occlusion enhanced by hyperoncotic lung distension: is there a role in the treatment of fetal pulmonary hypoplasia from early preterm premature rupture of membranes?

Fetal Diagn Ther. 2007;22(6):462-5. doi: 10.1159/000106356. Epub 2007 Jul 24.

Abstract

Objectives: To assess the effect of fetoscopic tracheal occlusion (FETO) enhanced by hyperoncotic distension on pulmonary hypoplasia from preterm premature rupture of membranes prior to 22 weeks of gestation (ePPROM).

Methods and results: In a fetus with ePPROM since 19+5 weeks of gestation, MRI at 28+2 weeks provided a lung volume of 10 ml. FETO enhanced by hyperoncotic distension was performed at 28+3 weeks. After 4-5 days, balloon dislodgement was observed. The lung volume increased to 18 ml. The baby was born at 32+4 weeks and survived to discharge.

Conclusions: FETO enhanced by hyperoncotic distension may result in impressive lung distension in fetuses with pulmonary hypoplasia from ePPROM. Further research into the life saving potential of this strategy for this common and tragic gestational event is desired.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Balloon Occlusion / methods*
  • Female
  • Fetal Diseases / diagnosis
  • Fetal Diseases / therapy*
  • Fetal Membranes, Premature Rupture / diagnosis
  • Fetal Membranes, Premature Rupture / therapy*
  • Fetoscopy / methods*
  • Humans
  • Infant, Newborn
  • Lung / ultrastructure
  • Lung Diseases / diagnosis
  • Lung Diseases / therapy*
  • Pregnancy
  • Premature Birth / diagnostic imaging
  • Premature Birth / therapy
  • Trachea / ultrastructure
  • Ultrasonography