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.