Complete resolution of hydrops by placement of double basket catheter in a case of macrocystic type multilocular pulmonary sequestration

Taiwan J Obstet Gynecol. 2017 Jun;56(3):402-405. doi: 10.1016/j.tjog.2017.04.027.

Abstract

Objective: We presented a fetus affected by macrocystic lung lesions with progressive hydropic changes during the second trimester, but experienced remarkable resolution of hydrops in the third trimester after a series of in utero interventions.

Case report: A 19-year-old women, G1P0, presented with fetal multilocular thoracic mass and hydropic change at 23+4 weeks of gestation. After non-directive genetic counseling, she opted for intrauterine cyst aspiration followed by intra-cystic OK-432 injection at 24 weeks of pregnancy, as well as sequential thoracoamniotic shunts at 26 weeks and 27+3 weeks of pregnancy when we observed hydrops developed progressively. Finally, the hydrops resolved in the third trimester and a healthy baby was born at 33+3 weeks of pregnancy, in which further surgical intervention was performed at five-month old.

Conclusion: Thoracoamniotic shunting is a preferred option for all hydropic fetuses resulted from large macrocystic lung lesions to enhance perinatal survival rate.

Keywords: Congenital lung cyst; Hydrops fetalis; Macrocystic lung lesions; Prenatal intervention; Thoracoamniotic shunts.

Publication types

  • Case Reports

MeSH terms

  • Bronchopulmonary Sequestration*
  • Catheterization / methods
  • Cesarean Section
  • Drainage / methods*
  • Female
  • Fetoscopy / methods
  • Humans
  • Hydrops Fetalis / diagnostic imaging
  • Hydrops Fetalis / surgery*
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Pleural Effusion / congenital
  • Pleural Effusion / diagnostic imaging
  • Pleural Effusion / surgery*
  • Pregnancy
  • Thoracostomy
  • Ultrasonography, Doppler, Color
  • Ultrasonography, Prenatal
  • Young Adult