Biomaterial Database

Prenatal diagnosis and management of fetal thoracic lesions. 1994

L Morin, and T M Crombleholme, and M E D'Alton

Fetal Treatment Program, Tufts University School of Medicine, Boston, MA.

There have been significant strides made during the last decade in understanding the natural history and pathophysiology of fetal thoracic lesions. Largely as a result of advances in prenatal ultrasound, we are not only able to diagnose these lesions and advise parents about prognosis, but also offer the possibility of fetal intervention for the most severely affected fetuses. However, large gaps remain in the current state of knowledge of fetal thoracic lesions. We are unable to accurately predict pulmonary hypoplasia, the most devastating consequence of fetal thoracic lesions. In lesions, such as CDH, the selection criteria for fetal intervention remain ill defined. Proof of the efficacy and superiority of fetal surgery over conventional postnatal therapies for diaphragmatic hernia await the results of prospective trials. Fetal surgery in lesions such as CCAM and BPS is currently reserved for only those fetuses with hydrops and a uniformly fatal outcome. Whether fetal surgery in these cases would be beneficial in the absence of hydrops is difficult to say especially given the possibility of spontaneous regression. During the next decade we anticipate continued growth in our understanding of these lesions, refinement in selection criteria for intervention, and advances in techniques for salvaging these severely compromised fetuses. The diagnosis and treatment of fetal thoracic lesions remains a formidable challenge, but one which can be met with cautious optimism, due to the availability of fetal interventions not previously available.

UI	MeSH Term	Description	Entries
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011296	Prenatal Diagnosis	Determination of the nature of a pathological condition or disease in the postimplantation EMBRYO; FETUS; or pregnant female before birth.	Diagnosis, Prenatal,Fetal Diagnosis,Fetal Imaging,Fetal Screening,Intrauterine Diagnosis,Antenatal Diagnosis,Antenatal Screening,Diagnosis, Antenatal,Diagnosis, Intrauterine,Prenatal Screening,Antenatal Diagnoses,Antenatal Screenings,Diagnosis, Fetal,Fetal Diagnoses,Fetal Imagings,Fetal Screenings,Imaging, Fetal,Intrauterine Diagnoses,Prenatal Diagnoses,Prenatal Screenings,Screening, Antenatal,Screening, Fetal,Screening, Prenatal
D001998	Bronchopulmonary Sequestration	A developmental anomaly in which a mass of nonfunctioning lung tissue lacks normal connection with the tracheobroncheal tree and receives an anomalous blood supply originating from the descending thoracic or abdominal aorta. The mass may be extralobar, i.e., completely separated from normally connected lung, or intralobar, i.e., partly surrounded by normal lung.	Pulmonary Sequestration,Bronchopulmonary Sequestrations,Pulmonary Sequestrations,Sequestration, Bronchopulmonary,Sequestration, Pulmonary,Sequestrations, Bronchopulmonary,Sequestrations, Pulmonary
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006876	Hydrothorax	A collection of watery fluid in the pleural cavity. (Dorland, 27th ed)
D013896	Thoracic Diseases	Disorders affecting the organs of the thorax.	Disease, Thoracic,Diseases, Thoracic,Thoracic Disease
D015615	Cystic Adenomatoid Malformation of Lung, Congenital	An abnormality in lung development that is characterized by a multicystic mass resulting from an adenomatous overgrowth of the terminal BRONCHIOLES with a consequent reduction of PULMONARY ALVEOLI. This anomaly is classified into three types by the cyst size.	Congenital Cystic Adenomatoid Malformation,Congenital Cystic Adenomatoid Malformation of Lung,Congenital Cystic Adenomatoid Malformation, Type 1,Congenital Cystic Adenomatoid Malformation, Type 2,Congenital Cystic Adenomatoid Malformation, Type 3,Congenital Cystic Adenomatoid Malformation, Type I,Congenital Cystic Adenomatoid Malformation, Type II,Congenital Cystic Adenomatoid Malformation, Type III,Cystic Adenomatoid Malformation of Lung,Lung Malformation, Congenital Cystic Adenomatoid,Lung Malformation, Cystic Adenomatoid, Congenital
D016216	Ultrasonography, Prenatal	The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.	Fetal Ultrasonography,Prenatal Diagnosis, Ultrasonic,Ultrasonography, Fetal,Diagnosis, Prenatal Ultrasonic,Diagnosis, Ultrasonic Prenatal,Prenatal Ultrasonic Diagnosis,Prenatal Ultrasonography,Ultrasonic Diagnosis, Prenatal,Ultrasonic Prenatal Diagnosis,Diagnoses, Prenatal Ultrasonic,Diagnoses, Ultrasonic Prenatal,Prenatal Diagnoses, Ultrasonic,Prenatal Ultrasonic Diagnoses,Ultrasonic Diagnoses, Prenatal,Ultrasonic Prenatal Diagnoses
D065630	Hernias, Diaphragmatic, Congenital	Protrusion of abdominal structures into the THORAX as a result of embryologic defects in the DIAPHRAGM often present in the neonatal period. It can be isolated, syndromic, non-syndromic or be a part of chromosome abnormality. Associated pulmonary hypoplasia and PULMONARY HYPERTENSION can further complicate stabilization and surgical intervention.	Bochdalek Hernia,Congenital Diaphragmatic Hernia,Congenital Diaphragmatic Hernias,Morgagni Hernia,Morgagni's Hernia,Agenesis of Hemidiaphragm,Bochdalek Hernias,Congenital Diaphragmatic Defect,Morgagni Hernias,Morgagni's Hernias,Unilateral Agenesis of Diaphragm,Congenital Diaphragmatic Defects,Defect, Congenital Diaphragmatic,Defects, Congenital Diaphragmatic,Diaphragm Unilateral Ageneses,Diaphragm Unilateral Agenesis,Diaphragmatic Defect, Congenital,Diaphragmatic Defects, Congenital,Diaphragmatic Hernia, Congenital,Diaphragmatic Hernias, Congenital,Hemidiaphragm Ageneses,Hemidiaphragm Agenesis,Hernia, Bochdalek,Hernia, Congenital Diaphragmatic,Hernia, Morgagni,Hernia, Morgagni's,Hernias, Bochdalek,Hernias, Congenital Diaphragmatic,Hernias, Morgagni,Hernias, Morgagni's,Morgagnis Hernia,Morgagnis Hernias