Antenatal Diagnosis of Congenital Fetal Lung Lesions and Postnatal Outcome — A Case Series and Review of the Literature

Abstract

Objectives: To review our local experience of prenatal diagnosis and management of congenital fetal lung lesions, and to compare the pregnancy outcomes with those published in the literature.
Methods: A retrospective study of all cases with antenatal diagnosis of congenital fetal lung malformations from January 2003 to December 2012 was performed. Outcomes of these pregnancies and neonatal records were reviewed to assess the antenatal course, management, and postnatal outcome.
Results: Of 48,619 deliveries, 15 cases of congenital lung lesions were diagnosed during this period, giving an incidence of 0.03%. All fetuses carried normal karyotype. Two fetuses had concurrent structural abnormalities. Two patients opted for termination of pregnancy, one because of macrocystic lesions and the other for concurrent structural abnormalities. The remaining 13 pregnancies were carried to term without specific antenatal intervention. Only one baby was symptomatic shortly after birth, while the others remained largely asymptomatic. Two babies underwent surgical excision of lung lesions. There was no antenatal fetal hydrops or perinatal mortality in this cohort.
Conclusion: Congenital fetal lung lesions were uncommon in our locality; most had good outcome and did not require any antenatal intervention. The spectrum of severity encountered was apparently milder than that reported in the literature. Postnatal paediatric assessment and further imaging of the lung lesions are essential.