Percutaneous ultrasound-guided sclerotherapy for complicated fetal intralobar bronchopulmonary sequestration

C. Bermúdez, J. Pérez-Wulff, G. Bufalino, C. Sosa, L. Gómez, R. A. Quintero

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Bronchopulmonary sequestration (BPS), which can be intralobar or extralobar, is a rare developmental anomaly of the lung characterized by nonfunctional pulmonary tissue without communication with the tracheobronchial tree and with an aberrant systemic arterial blood supply. The intralobar type is typically within the pleural cavity with an arterial feeding vessel generally arising from the thoracic aorta and with venous drainage into the left atrium. The prognosis is poor in cases diagnosed before 26 weeks' gestation and when there is mediastinal shift, polyhydramnios and fetal hydrops. The ideal prenatal management option remains undefined. We present a series of three complicated cases of intralobar BPS treated prenatally with percutaneous ultrasound-guided fetal sclerotherapy (FST). The feeding vessel was successfully accessed percutaneously under ultrasound guidance in all cases. FST with polidocanol resulted in complete obliteration of the blood flow to the mass. Abnormal Doppler findings, ascites, hydrops and polyhydramnios resolved and all patients were delivered at term. Antenatal treatment of patients with complicated BPS can be successfully achieved with FST, which is a simple and inexpensive technique. Comparison of risks and benefits of this approach with other techniques is warranted.

Original languageEnglish (US)
Pages (from-to)586-589
Number of pages4
JournalUltrasound in Obstetrics and Gynecology
Volume29
Issue number5
DOIs
StatePublished - May 1 2007

Keywords

  • Fetal hydrops
  • Fetal therapy
  • Lung mass
  • Polidocanol
  • Pulmonary sequestration
  • Sclerotherapy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Acoustics and Ultrasonics

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