Çocuk Sağlığı ve Hastalıkları Dergisi 2013 , Vol 56 , Num 2
Postnatal follow-up of infants diagnosed with congenital cystic adenomatoid malformation prenatally
*Sevgi Köstel1, Özge Sürmeli Onay2 Mert Tuğral3, Özgür Özyüncü4, Deniz Doğru Ersöz5, Şahin Takcı2, Şule Yiğit5, Ayşe Korkmaz Toygar6, Nural Kiper5, Murat Yurdakök5
Hacettepe Üniversitesi Tıp Fakültesi 1Pediatri Araştırma Görevlisi, 2Pediatri Uzmanı,3Kadın Hastalıkları ve Doğum Uzmanı, 4Kadın Hastalıkları ve Doğum Doçenti, 5Pediatri Profesörü, 6Pediatri Doçenti *İletişim: ozgeonay79@gmail.com Congenital cystic adenomatoid malformation (CCAM) is a congenital hamartomatous lesion of the lung, characterized by aberrant proliferation of terminal bronchioles together with various cystic and solid structures. This entity was renamed recently as congenital pulmonary airway malformations (CPAM). Ultrasonography is the chief modality for prenatal diagnosis between 16-32 weeks of pregnancy. Polyhydramnios, hydrops, pulmonary hypoplasia, and mediastinal shift can also be detected synchronously. In this study, we evaluated retrospectively the records of infants prenatally diagnosed with CPAM who were hospitalized between 2001 and 2012 in Hacettepe University İhsan Doğramacı Children’s Hospital, Neonatal Intensive Care Unit. Prenatal diagnosis and postnatal outcome were compared. In the last 10 years, nine neonates were born with a prenatal CPAM diagnosis. 66.7% of the infants were asymptomatic. Complications such as polyhydramnios, hydrops, pulmonary hypoplasia, and mediastinal shift were not observed in any of the cases. The mean follow-up period was 3±3.7 years; two cases dropped out in the long-term follow-up. Postnatally, two cases were diagnosed with pulmonary sequestration (22.2%), one with CCAM type 1 (11.1%), one with thymic cyst (11.1%), one with bronchogenic cyst (11.1%), and one with congenital lobar emphysema (11.1%). Spontaneous resolution of the cysts was observed in two cases. As a result of recurrent pneumonia, lobectomy was performed in one case; it was diagnosed pathologically as CCAM type I. There was no mortality. In conclusion, although discrepancies exist between antenatal and postnatal diagnoses, ultrasonography has an important role in both the diagnosis and management of CPAM. Anahtar Kelimeler : konjenital kistik adenomatoid malformasyon, konjenital pulmoner hava yolu malformasyonu, yenidoğan, ultrasonografi.
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