Fetal bronchoscopy: its successful use in a case of extralobar pulmonary sequestration

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 25; no. 11; pp. 2354 - 2358
• Main Authors: Quintero, Ruben A., Kontopoulos, Eftichia, Reiter, Joel, Pedreira, Wilson L., Colin, Andrew A.
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01-11-2012; Taylor & Francis
• Subjects: Bronchopulmonary Sequestration - diagnosis; Bronchopulmonary Sequestration - therapy; Bronchoscopy - methods; Diagnosis, Differential; Female; Fetal Diseases - diagnosis; Fetal Diseases - surgery; Fetal laryngoscpy; fetal therapy; fetoscopy; Fetoscopy - methods; Fetus - surgery; Humans; Pregnancy; pulmonary sequestration; Treatment Outcome; ultrasound; Young Adult
• ISSN: 1476-7058; 1476-4954
• DOI: 10.3109/14767058.2012.695826

Objective: To report the performance of fetal bronchoscopy in a case of pulmonary sequestration. Materials and Methods: A 24 year-old female, Gravida 2, Para 1, was referred at 27.5 weeks with a large fetal left lung mass with marked right mediastinal shift and no visible normal left lung. Differential diagnosis included possible bronchial atresia. Results: The patient underwent fetal laryngoscopy and fetal bronchoscopy at 31.5 weeks. The right lung and a portion of the left lung expanded during surgery as a result of bronchial lavage. Bronchial atresia or bronchogenic cyst were not found. Pregnancy continued uneventfully, with continuous growth of the right lung and a small amount of left lung. The patient delivered vaginally at term. The baby underwent thoracoscopic resection of a pulmonary sequestration at 10.5 months of age and did well. Conclusion: Fetal bronchoscopy is feasible. The procedure may prove useful in the differential diagnosis and in the potential treatment of different fetal lung lesions, as well as aid in the understanding of the role of bronchial obstruction as a common pathophysiologic mechanism for different fetal lung masses. Risks and benefits of fetal bronchoscopy warrant further experience.