Neonatal Outcomes of Prenatally Diagnosed Congenital Pulmonary Malformations
| Autor: | Christophe Delacourt, Guillaume Lezmi, Guillaume Thouvenin, Laurent Salomon, Elise Leroy-Terquem, Caroline Thumerelle, Isabelle Ruchonnet-Metrailler, André Labbé, Pierrick Cros, Naziha Khen-Dunlop, Fouad Madhi, Heloise Ducoin, Alice Hadchouel, Julien Stirnemann, Marie-Noëlle Lebras, Géraldine Labouret |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
Polyhydramnios Pediatrics medicine.medical_specialty Statistics as Topic Prenatal diagnosis Gestational Age Ultrasonography Prenatal Pregnancy Risk Factors Cystic Adenomatoid Malformation of Lung Congenital Ascites medicine Humans Bronchopulmonary Sequestration Prospective Studies Registries Respiratory system Lung Fetus Respiratory Distress Syndrome Newborn Respiratory distress business.industry Infant Newborn Pregnancy Outcome medicine.disease medicine.anatomical_structure Pregnancy Trimester Second Pediatrics Perinatology and Child Health Breathing Female medicine.symptom business |
| Zdroj: | Pediatrics, Vol. 133, No 5 (2014) pp. e1285-e1291 |
| ISSN: | 0031-4005 |
| Popis: | BACKGROUND AND OBJECTIVE: Congenital pulmonary malformations (CPM) are mostly recognized on prenatal ultrasound scans. In a minority of cases, they may impair breathing at birth. The factors predictive of neonatal respiratory distress are not well defined, but an understanding of these factors is essential for decisions concerning the need for the delivery to take place in a tertiary care center. The aim of this study was to identify potential predictors of respiratory distress in neonates with CPM. METHODS: We selected cases of prenatal diagnosis of hyperechoic and/or cystic lung lesions from RespiRare, the French prospective multicenter registry for liveborn children with rare respiratory diseases (2008–2013). Prenatal parameters were correlated with neonatal respiratory outcome. RESULTS: Data were analyzed for 89 children, 22 (25%) of whom had abnormal breathing at birth. Severe respiratory distress, requiring oxygen supplementation or ventilatory support, was observed in 12 neonates (13%). Respiratory distress at birth was significantly associated with the following prenatal parameters: mediastinal shift (P = .0003), polyhydramnios (P = .05), ascites (P = .0005), maximum prenatal malformation area (P = .001), and maximum congenital pulmonary malformation volume ratio (CVR) (P = .001). Severe respiratory distress, requiring oxygen at birth, was best predicted by polyhydramnios, ascites, or a CVR >0.84. CONCLUSIONS: CVR >0.84, polyhydramnios, and ascites increased the risk of respiratory complications at birth in fetuses with CPM, and especially of severe respiratory distress, requiring oxygen supplementation or more intensive intervention. In such situations, the delivery should take place in a tertiary care center. |
| Databáze: | OpenAIRE |
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