Universität zu Köln

Hellmund, Astrid, Berg, Christoph, Geipel, Annegret, Bludau, Meike, Heydweiller, Andreas, Bachour, Haitham, Mueller, Andreas, Mueller, Annette and Gembruch, Ulrich ORCID: 0000-0001-8284-4669 (2016). Prenatal Diagnosis and Evaluation of Sonographic Predictors for Intervention and Adverse Outcome in Congenital Pulmonary Airway Malformation. PLoS One, 11 (3). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Objective To describe antenatal findings and evaluate prenatal risk parameters for adverse outcome or need for intervention in fetuses with congenital pulmonary airway malformation (CPAM). Methods In our retrospective study all fetuses with a prenatal diagnosis of CPAM detected in our tertiary referral center between 2002 and 2013 were analyzed. Sonographic findings were noted and measurements of mass-to-thorax-ratio (MTR), congenital pulmonary airway malformation volume-ratio (CVR) and observed to expected lung-to head-ratio (o/e LHR) were conducted and correlated to fetal or neonatal morbidity and mortality and/or need for prenatal intervention. Results 67 fetuses with CPAM were included in the study. Hydropic fetuses were observed in 16.4% (11/67) of cases, prenatal intervention was undertaken in 9 cases; 7 pregnancies were terminated. The survival rate of non-hydropic fetuses with conservatively managed CPAM was 98.0%(50/51), the survival rate for hydropic fetuses with intention to treat was 42.9% (3/7). 10 (18.2%) children needed respiratory assistance. Fetuses with a CVR of <0.91 were significantly less likely to experience adverse outcome or need for prenatal intervention with sensitivity, specificity and positive/negative predictive value of 0.89, 0.71, 0.62 and 0.93, respectively. A MTR (mass-to-thorax-ratio) of <0.51 had a positive predictive value of 0.54 and a negative predictive value of 0.96 of adverse events with a sensitivity of 0.95 and a specificity of 0.63. The negative predictive value for o/e LHR of 45% was 0.84 with sensitivity, specificity and positive predictive value of 0.73, 0.68 and 0.52, respectively. Conclusions The majority of cases with CPAM have a favorable outcome. MTR and CVR are able to identify fetuses at risk, the o/e LHR is less sensitive.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hellmund, Astrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Berg, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Geipel, Annegret UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Meike UNSPECIFIED UNSPECIFIED UNSPECIFIED Heydweiller, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachour, Haitham UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Annette UNSPECIFIED UNSPECIFIED UNSPECIFIED Gembruch, Ulrich UNSPECIFIED orcid.org/0000-0001-8284-4669 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-281285
DOI:	10.1371/journal.pone.0150474
Journal or Publication Title:	PLoS One
Volume:	11
Number:	3
Date:	2016
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CYSTIC ADENOMATOID MALFORMATION; FETAL LUNG LESIONS; EXTRACORPOREAL MEMBRANE-OXYGENATION; HEAD CIRCUMFERENCE RATIO; DIAPHRAGMATIC-HERNIA; BRONCHIOLOALVEOLAR CARCINOMA; PLEUROPULMONARY BLASTOMA; MANAGEMENT; HYDROPS; EXPERIENCE Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28128