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Article: Management and outcome of antenatally diagnosed congenital cystic adenomatoid malformation of the lung

TitleManagement and outcome of antenatally diagnosed congenital cystic adenomatoid malformation of the lung
Authors
KeywordsCystic adenomatoid malformation of lung, congenital
Prenatal diagnosis
Treatment outcome
Issue Date2007
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk
Citation
Hong Kong Medical Journal, 2007, v. 13 n. 1, p. 31-39 How to Cite?
AbstractObjective: To review the management and outcome of babies with antenatally diagnosed congenital cystic adenomatoid malformation. Design: Retrospective cohort review. Setting: Tertiary neonatal care unit at Queen Mary Hospital and antenatal diagnostic centre at Tsan Yuk Hospital. Patients: Consecutive patients with antenatally suspected congenital cystic adenomatoid malformation in their concepti among antenatal patients attending Tsan Yuk Hospital from 1994 to 2002. Twenty-four of 33 cases were referred to Queen Mary Hospital for postnatal management and for whom comprehensive records were available for analysis in 23. Interventions: Postnatal interventions in their babies included investigational imaging for congenital cystic adenomatoid malformation and surgery. Main outcome measures: Antenatal and postnatal outcome, as well as pathology of the excised lesions. Results: Antenatal outcome: termination of pregnancy in two cases and spontaneous abortion in one; in-utero regression was documented in nine cases and in one hydropic change was apparent. Postnatal outcome: only eight of 20 babies born alive had symptoms in neonatal period. Two developed serious infective complications in infancy, one with documented in-utero regression. Pulmonary parenchymal abnormalities were detected on computed tomography of the thorax in six of seven cases with normal or non-specific chest radiograph findings. Among nine cases with in-utero regression, congenital cystic adenomatoid malformation was confirmed by operative histology in five and abnormal computed tomography findings in three. Fifteen babies underwent surgical excision, one of whom died because of severe pre-existing pulmonary hypoplasia and nine endured minor postoperative complications. A favourable outcome was documented at a mean follow-up of 22 months (range, 2 months-7 years). Conclusions: In-utero regression of congenital cystic adenomatoid malformation on antenatal ultrasound may not represent genuine resolution. Computed tomographic thorax should be considered in all newborns with antenatally diagnosed congenital cystic adenomatoid malformation, and if confirmed early operation before first hospital discharge is recommended.
Persistent Identifierhttp://hdl.handle.net/10722/57409
ISSN
2014 Impact Factor: 0.872
2014 SCImago Journal Rankings: 0.237
References

 

DC FieldValueLanguage
dc.contributor.authorChow, PCen_HK
dc.contributor.authorLee, SLen_HK
dc.contributor.authorTang, MHYen_HK
dc.contributor.authorChan, KLen_HK
dc.contributor.authorLee, CPen_HK
dc.contributor.authorLam, BCCen_HK
dc.contributor.authorTsoi, NSen_HK
dc.date.accessioned2010-04-12T01:35:44Z-
dc.date.available2010-04-12T01:35:44Z-
dc.date.issued2007en_HK
dc.identifier.citationHong Kong Medical Journal, 2007, v. 13 n. 1, p. 31-39en_HK
dc.identifier.issn1024-2708en_HK
dc.identifier.urihttp://hdl.handle.net/10722/57409-
dc.description.abstractObjective: To review the management and outcome of babies with antenatally diagnosed congenital cystic adenomatoid malformation. Design: Retrospective cohort review. Setting: Tertiary neonatal care unit at Queen Mary Hospital and antenatal diagnostic centre at Tsan Yuk Hospital. Patients: Consecutive patients with antenatally suspected congenital cystic adenomatoid malformation in their concepti among antenatal patients attending Tsan Yuk Hospital from 1994 to 2002. Twenty-four of 33 cases were referred to Queen Mary Hospital for postnatal management and for whom comprehensive records were available for analysis in 23. Interventions: Postnatal interventions in their babies included investigational imaging for congenital cystic adenomatoid malformation and surgery. Main outcome measures: Antenatal and postnatal outcome, as well as pathology of the excised lesions. Results: Antenatal outcome: termination of pregnancy in two cases and spontaneous abortion in one; in-utero regression was documented in nine cases and in one hydropic change was apparent. Postnatal outcome: only eight of 20 babies born alive had symptoms in neonatal period. Two developed serious infective complications in infancy, one with documented in-utero regression. Pulmonary parenchymal abnormalities were detected on computed tomography of the thorax in six of seven cases with normal or non-specific chest radiograph findings. Among nine cases with in-utero regression, congenital cystic adenomatoid malformation was confirmed by operative histology in five and abnormal computed tomography findings in three. Fifteen babies underwent surgical excision, one of whom died because of severe pre-existing pulmonary hypoplasia and nine endured minor postoperative complications. A favourable outcome was documented at a mean follow-up of 22 months (range, 2 months-7 years). Conclusions: In-utero regression of congenital cystic adenomatoid malformation on antenatal ultrasound may not represent genuine resolution. Computed tomographic thorax should be considered in all newborns with antenatally diagnosed congenital cystic adenomatoid malformation, and if confirmed early operation before first hospital discharge is recommended.en_HK
dc.languageengen_HK
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hken_HK
dc.relation.ispartofHong Kong Medical Journalen_HK
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Medical Association.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectCystic adenomatoid malformation of lung, congenitalen_HK
dc.subjectPrenatal diagnosisen_HK
dc.subjectTreatment outcomeen_HK
dc.titleManagement and outcome of antenatally diagnosed congenital cystic adenomatoid malformation of the lungen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1024-2708&volume=13&issue=1&spage=31&epage=39&date=2007&atitle=Management+and+outcome+of+antenatally+diagnosed+congenital+cystic+adenomatoid+malformation+of+the+lungen_HK
dc.identifier.emailTang, MHY: mhytang@hkucc.hku.hken_HK
dc.identifier.authorityTang, MHY=rp01701en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid17277390-
dc.identifier.scopuseid_2-s2.0-33947603060en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33947603060&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume13en_HK
dc.identifier.issue1en_HK
dc.identifier.spage31en_HK
dc.identifier.epage39en_HK
dc.publisher.placeHong Kongen_HK
dc.identifier.scopusauthoridChow, PC=23099233800en_HK
dc.identifier.scopusauthoridLee, SL=7601408235en_HK
dc.identifier.scopusauthoridTang, MHY=8943401300en_HK
dc.identifier.scopusauthoridChan, KL=37004089600en_HK
dc.identifier.scopusauthoridLee, CP=7410149538en_HK
dc.identifier.scopusauthoridLam, BCC=8553938300en_HK
dc.identifier.scopusauthoridTsoi, NS=6603693887en_HK

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