Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 3 , Pages 278-281, September 2009

Prenatal Diagnosis of Congenital Cystic Adenomatoid Malformations: Evolution and Outcome

  • Wei-Shiu Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
    • ,
  • Guang-Perng Yeh

      Affiliations

    • Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
    • Department of Obstetrics and Gynecology, Chung-Shan Medical University, Taichung, Taiwan
    • ,
  • Horng-Der Tsai

      Affiliations

    • Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
    • ,
  • Charles Tsung-Che Hsieh

      Affiliations

    • Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Charles Tsung-Che Hsieh, Department of Obstetrics and Gynecology, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua 500, Taiwan

Accepted 16 July 2008.

Article Outline

Summary 

Objective

The aim of this study was to describe the natural history and outcomes of fetal congenital cystic adenomatoid malformation (CCAM) of the lung in three antenatally diagnosed cases.

Case Report

Three women whose fetuses had CCAM of the lung between 2004 and 2006 chose to continue their pregnancies. We followed up these fetuses every 2 weeks and observed whether there were CCAM-related complications, such as polyhydramnios, mediastinal shifting, and even hydrops fetalis. We also used three- dimensional ultrasound using the VOCAL (Virtual Organ Computer-aided Analysis) rotational technique to calculate CCAM volume serially until delivery. At presentation, the three cases of fetal CCAM were all unilateral and microcystic. Two were complicated by mediastinal shift, but none had hydrops fetalis. Serial ultrasound volumetry demonstrated a trend toward a decreasing CCAM volume, despite an initial increase in volume. Complete resolution was noted in two cases by antenatal sonography. However, persistent lung lesions were found in two cases by postnatal chest radiography and in all cases by postnatal computed tomography scans.

Conclusion

The outcomes of the prenatally detected CCAMs were good in our cases. If the CCAM is not complicated by hydrops fetalis, maintaining the pregnancy with continuing management seems to be a reasonable recommendation. Despite antenatal resolution of CCAM on ultrasound, postnatal examination with chest radiography and computed tomography scan is necessary.

Key Words:  congenital cystic adenomatoid malformation , fetal monitoring , pregnancy outcome

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PII: S1028-4559(09)60304-1

doi:10.1016/S1028-4559(09)60304-1

Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 3 , Pages 278-281, September 2009

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