UNILATERAL CERVICAL SPINAL-CORD LESION IN A TERM NEWBORN, ASSOCIATED WITH IPSILATERAL DIAPHRAGMATIC ATROPHY AND PULMONARY HYPOPLASIA

Two major factors can interfere with normal development of the fetal l ungs: mechanical constriction resulting in decreased intrathoracic spa ce and reduced or absent fetal breathing movements. We report a unique case in which both factors contribute to the development of lethal pu lmonary hypoplasia. This full-term neonate had an isolated unilateral lesion in the cervical spinal cord resulting in ipsilateral neurogenic atrophy of the diaphragm, bilateral pulmonary hypoplasia, and lung im maturity. Evenetration of the atrophied diaphragm decreased intrathora cic space, compromising fetal lung growth. This was compounded by impa ired fetal respiration due to the diaphragmatic atrophy, further aggra vating pulmonary hypoplasia on the affected side. The other lung was a lso hypoplastic, although to a lesser degree, suggesting that its grow th was also affected by either or both of these factors. (C) 1994 Wile y-Liss, Inc.