Outcome of fetal congenital pulmonary malformations: a systematic review and meta-analysis.

Autor:	Sileo FG; Prenatal Medicine Unit, Obstetrics and Gynaecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy.; Department of Biomedical, Metabolic and Neural Sciences, International Doctorate School in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy., Alameddine S; Department of Obstetrics and Gynaecology, University of Chieti, Chieti, Italy., Iaccarino DA; Department of Obstetrics and Gynaecology, University of Chieti, Chieti, Italy., Di Mascio D; Department of Maternal and Child Health and Urological Sciences, 9311 Sapienza University of Rome , Rome, Italy., Giuliani GA; Prenatal Medicine Unit, Obstetrics and Gynaecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy.; Department of Obstetrics and Gynaecology, University of Chieti, Chieti, Italy., Bertucci E; Prenatal Medicine Unit, Obstetrics and Gynaecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy., Khalil A; Fetal Medicine Unit, Saint George's Hospital, London, UK.; Fetal Medicine Unit, Liverpool Women's Hospital, Liverpool, UK., D'Antonio F; Department of Obstetrics and Gynaecology, University of Chieti, Chieti, Italy.
Jazyk:	angličtina
Zdroj:	Journal of perinatal medicine [J Perinat Med] 2024 Apr 24; Vol. 52 (5), pp. 457-466. Date of Electronic Publication: 2024 Apr 24 (Print Publication: 2024).
DOI:	10.1515/jpm-2024-0017
Abstrakt:	Objectives: To report the outcome of fetuses with a prenatal diagnosis of congenital lung malformation (CLM) diagnosed on ultrasound by performing a comprehensive assessment of these outcomes through a systematic review and meta-analysis. Content: CLMs are a heterogeneous group of anomalies that involve the lung parenchyma and its bronchovascular structures. Their presentation and evolution are variable, from entirely asymptomatic lesions with sonographic regression in utero to hydropic fetuses requiring fetal therapy, intrauterine death or neonatal morbidity. A systematic review was conducted in Medline, Embase and Cochrane databases including studies on fetuses with CLM diagnosed prenatally in order to report the in-utero natural history of these lesions. Thirty-nine studies (2,638 fetuses) were included in the final review. Summary: Regression/reduction in size of the lung lesion during pregnancy was reported in 31 % of cases, while its increase in 8.5 % of cases. Intra-uterine death complicated 1.5 % of pregnancies with fetal CLM, while neonatal and perinatal death were 2.2 and 3 %, respectively. Neonatal morbidity occurred in 20.6 % of newborns with CLM; 46 % had surgery, mainly elective. In fetuses with CLM and hydrops, fetal/perinatal loss occurred in 42 %. Assessment of the role of fetal therapy in improving the outcomes of pregnancies complicated by CLM was hampered by the small number of included cases and heterogeneity of type of interventions. Outlook: Fetuses with CLM prenatally diagnosed have a generally favorable outcome. Conversely, there is a low quality of evidence on the actual role of fetal therapy in improving the outcome of fetuses presenting with these anomalies. (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)
Databáze:	MEDLINE
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