Outcome of congenital lung abnormalities detected antenatally

To determine the outcome of congenital lung abnormalities, data were collec ted retrospectively between January 1991 and December 1996 on any foetus fo und to have a lung lesion on antenatal ultrasound. A total of 23 foetuses h ad lung lesions on antenatal ultrasound. In two foetuses the antenatal ultr asound showed bilateral enlarged "bright" echogenic lungs with evidence of hydrops. Both pregnancies were terminated and tracheal atresia was confirme d. In 15 foetuses the antenatal ultrasound appearance was of a unilateral " bright" echogenic lung. There was one case of bronchial atresia and two cas es of congenital lobar emphysema, which all had surgery. In nine cases ther e was a reduction in the size of the lesion on serial antenatal ultrasounds and no lesion was detected after birth. In three cases a small lesion was present after birth on chest radiography. In six foetuses the antenatal ult rasound appearance was of unilateral cystic or mixed cystic and echogenic l ung lesions. Two pregnancies-were terminated; both had congenital cystic ad enomatoid malformation. Four pregnancies were continued and three infants h ad surgery soon after birth and were confirmed to have had congenital cysti c adenomatoid malformation. One infant has been managed conservatively. In conclusion, a definitive diagnosis cannot usually be made antenatally. A la rge lesion on initial scan does not necessarily predict a poor outcome. The natural history of small asymptomatic postnatal lesions is unknown and a l ong-term prospective study is needed to determine the outcome of these lesi ons.