Postnatal outcome
All 75 fetuses were alive at birth. The mean gestational age at birth
was 38.7 ±2.1 weeks and the mean weight at birth was 3208 ±486 g.
None of the patients with isolated mediastinal shift developed neonatal
symptoms (Figure 3 ). Seven patients (9%) showed neonatal
symptoms with respiratory distress. Two of them had spontaneous
resolution and 3 needed urgent intubation. Five of the 7 patients with
neonatal symptoms were diagnosed as CLE on the post-natal imaging, one
as BC and one with BPS. The symptoms appeared at birth in 5 cases, at
day 10 and day 28 in the other 2 cases. The two patients with acute
prenatal symptoms developed post-natal respiratory symptoms at birth
that lead to neonatal surgery. The patient with prenatal ascites and
compression died 4 days after the resection of a thoracic extralobar
sequestration, due to uncontrollable pulmonary arterial hypertension.
The other patient had an excision of the infected BC and was discharged
after 33 days. The details of patients with neonatal symptoms are
reported in Table I.
During the long-term follow up, 21 patients (28%) developed respiratory
symptoms: recurrent bronchiolitis or asthma in 14 and pulmonary or
bronchial infection in 7.
The diagnosis of these symptomatic cases was: PCM in 2 cases (9%),
hybrid malformations in 5 cases (24%), BPS in 9 cases (43%) and CLE in
5 cases (24%).
The details of the symptoms according to the final post-natal diagnosis
are described in Table II .
In total, 43 patients (57%) were operated. The mean age at surgery was
1.31 years (± 0.73).
The histological findings concluded to: 15 BPS (35%), 10 hybrid
malformations (23%), 5 PCM (12%), 8 CLE (18%) and 5 BC (12%)
(Figure 4 ).
At the last review, all the patients were symptom free.
Considering the type of the malformation on the post-natal CT scan,
surgery was realized in 5/5 of BC, 5/5 of PCM, 10/10 of hybrid
malformations, 15/25 BPS (60%) and 7/30 (23%) of CLE.