SUCCESSFUL PRENATAL MANAGEMENT OF HYDROPS, CAUSED BY CONGENITAL CYSTIC ADENOMATOID MALFORMATION, USING SERIAL ASPIRATIONS

Congenital cystic adenomatoid malformation (CCAM) is a lung lesion tha t is now commonly diagnosed in utero with fetal ultrasonography. The d escribed treatment of this lesion includes observation with treatment delivery, a single aspiration, thoraco-amniotic shunts, and fetal rese ction, This patient had an in utero diagnosis of a Stocker type I CCAM associated with hydrops, Fetal resection was not an option because of patient refusal. The fetus was treated with multiple serial aspiratio ns. There was marked improvement of the anasarca, and Subsequently the baby was born without respiratory distress. On the second day of life the CCAM began to expand, and the right lower lobe was resected, The baby's postoperative course was uneventful, CCAM with hydrops is assoc iated with a high mortality rate. Current recommended therapy for thes e lesions is fetal resection or thoracoamniotic shunt. The authors' pa tient was treated with serial fetal thoracocenteses, with an excellent outcome. This therapy may be an alternative to fetal surgery or an ad junct to fetal surgery in selected cases. Copyright (C) 1995 by W.B. S unders Company