Document Detail


To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report.
MedLine Citation:
PMID:  18853037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Macrocystic adenomatoid malformation of the lung can cause severe mediastinal shift, hydrops and polyhydramnios, thereby increasing the risk of perinatal deaths. After 33 weeks of gestation, repeated puncturing of the cyst is recommended. We present a case in which a cyst-amniotic shunt was placed instead of performing this procedure. CASE REPORT: A cyst-amniotic shunt was placed at 33 weeks of gestation because of a large macrocystic adenomatoid malformation of the lung associated with severe mediastinal shift and polyhydramnios. Although it was confirmed that the catheter was in the correct place, the cyst increased in size again two weeks later, associated with repetition of polyhydramnios. It was postulated that the catheter was blocked, and we chose to place another catheter instead of performing repeated punctures. The cystic volume, polyhydramnios and mediastinal shift regressed progressively. At 38.5 weeks, a 3,310/g male infant was delivered without presenting any respiratory distress. The infant underwent thoracotomy on the 15th day of life. Thus, in the present study, we discuss the possibility of placing a cyst-amniotic shunt instead of performing repeated cystic punctures, even at a gestational age close to full term.
Authors:
Rodrigo Ruano; Paula Beatriz Tavares Fettback; Vinicius Lima Ribeiro; Marcus Marques Silva; João Gilberto Maksoud; Marcelo Zugaib
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  São Paulo medical journal = Revista paulista de medicina     Volume:  126     ISSN:  1806-9460     ISO Abbreviation:  Sao Paulo Med J     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-10-14     Completed Date:  2009-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897261     Medline TA:  Sao Paulo Med J     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  239-41     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Fetal Medicine Unit, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil. rodrigoruano@usp.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Catheters, Indwelling*
Cystic Adenomatoid Malformation of Lung, Congenital / diagnosis,  therapy*
Female
Fetal Diseases / diagnosis,  therapy*
Fetal Therapies / methods
Humans
Infant, Newborn
Male
Polyhydramnios
Pregnancy
Pregnancy Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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