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Can we predict the need for postnatal surgery in patients with prenatal fetal lung masses detected by CVR value? - 25/01/23

Doi : 10.1016/j.jogoh.2022.102526 
Aydın Ocal a, , Oya Demirci a, Gizem Elif Dizdaroğulları a, Özge Kahramanoğlu a, Işıl Ayhan a, Münip Akalın a, b, Mucize Eriç Özdemir a, Ali Şahap Odacılar a, Ümit Taşdemir a, Ayşenur Celayir c
a Department of Obstetrics and Gynecology, Health Science University, Zeynep Kamil Women and Children's Diseases Training and Research Hospital,Istanbul, Turkey 
b Department of Perinatology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey 
c Department of Pediatric Surger, Health Science University, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey 

Corresponding author at: Health Science University, Zeynep Kamil Women and Health Science University, Department of Obstetrics and Gynecology, Children's Diseases Training and Research Hospital, Caferağa Mahallesi, Atıfet Sokak, Buket apt daire no 17 Kadıköy/İSTANBUL, Turkey.Health Science UniversityZeynep Kamil Women and Health Science UniversityDepartment of Obstetrics and GynecologyChildren's Diseases Training and Research HospitalCaferağa Mahallesi, Atıfet Sokak, Buket apt daire no 17 Kadıköy/İSTANBULTurkey

ABSTRACT

Aim

The purpose of this study is to evaluate whether CPAM-volume ratio (CVR) can predict postnatal management (follow up for resolution and surgical treatment) in fetuses with fetal lung masses in the prenatal period.

Materials and Methods

44 patients who presented at our center with prenatally diagnosed CPAM (Congenital Pulmonary Airway Malformation) and BPS (Bronchopulmonary Sequestration) were analyzed. Obstetric history and outcomes, karyotype results, CVR, additional sonographic findings, characteristics of masses were recorded. CVR was calculated for all cases. İn the study we sought to identify a CVR threshold and did not use the thresholds classically used in the literature.

Results

20 fetal BPS and 24 CPAM cases were analyzed. After excluding 5 patients, 46% of the patients were diagnosed with BPS and 54% with CPAM. İn this study the cut off < 0,53 for CVR is taken, it predicts the no need for postnatal surgery with a sensitivity of 85% and a specificity of 88%. When we take the > 0,76 cut-off value for patients who will require emergency surgery within the first 10 days, it predicts the need for surgery with 90% sensitivity and 89% specificity. In addition, it was determined that all patients with mediastinal shift were operated.

Conclusion

We believe that the CVR value and the presence of mediastinal shift should be evaluated in all cases of CPAM and BPS for prediction of the surgery. Proper counseling about the prognosis could be given to the family in cases with mediastinal shift and CVR value above 0,76.

Le texte complet de cet article est disponible en PDF.

Key Words : Bronchopulmonary sequestration, Congenital pulmonary airway malformation, CVR, Fetal lung masses, Prenatal ultrasound


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Vol 52 - N° 2

Article 102526- février 2023 Retour au numéro
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