Ultrasound-guided laser treatment of hydropic fetal lung lesions with a systemic arterial supply

Minimally invasive fetal therapy for hydropic lung masses: three different approaches and review of the literature

“…Less‐invasive approaches have been attempted to allow shrinkage of the lesion and recovery of the hydropic fetus (Table ). Including the three cases presented here, a total of 33 closed fetal interventions for mCCAM ( n = 10) or BPS ( n = 23) have been reported to date, including sclerotherapy ( n = 5) or laser coagulation ( n = 25) of the feeding vessel, with ( n = 3/25) or without ( n = 22/25) thoraco‐amniotic shunting. Encouraging preliminary results have also recently been reported following the use of antenatal steroids for large mCCAMs, but similar outcomes have never been documented for BPS.…”

Interstitial Laser Occlusion of the Systemic Feeding Vessel in a Hybrid Lung Lesion: Technique, Clinical Course, Perinatal Outcome and a Review of Literature

“…The mediastinal compression that a large lesion may cause and the related impairment of venous return is the primary reason for development of hydrops in BPS [1]. In the absence of severe pleural effusion or hydrops, BPS has a favourable prognosis with a high probability of spontaneous regression or excellent surgical outcomes in lesions that persist into postnatal life [7]. Such cases may be managed expectantly during the antenatal period.…”

“…On the other hand, lesions that result in fetal hydrops are associated with a high incidence of intrauterine demise or neonatal morbidity/mortality and are therefore a definitive indication for fetal therapy [8]. Several fetal therapeutic interventions have been proposed over the years to treat such lesions, some of which have been tabulated below (Table 1) [2,3,[7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Percutaneous laser ablation under ultrasound guidance for fetal hyperechogenic microcystic lung lesions with hydrops: a single center cohort and a literature review

“…19,23 Percutaneous laser ablation under ultrasound guidance provides an alternate therapeutic option. 5,15,28,[35][36][37][39][40][41][42] However, despite of being first reported in 1997 by Fortunato et al, 39 there are very few reported cases described in the literature. This cohort study and the review of the literature allows critical appraisal of such treatment.…”

“…By reviewing and critically appraising the literature, the results relating to outcome are very similar. 5,15,28,[35][36][37][39][40][41][42] There have been four cases reported in the literature with microcystic CCAM treated with 'interstitial laser ablation'. 5,15,28,39,40 Only two of them survived (50%); both had regression of hydrops after laser and had pathological confirmation of the diagnosis of CCAM.…”