The journal of obstetrics and gynaecology research · 2026
Congenital Pulmonary Airway Malformation Volume Ratio in Fetuses With Congenital Cystic Lung Diseases to Predict Surgery Within 7 Days of Birth.
СтатьяНазвание и аннотация: Перевод в очереди
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Yanagisawa Fumi, Kamihara Yuki, Shimokaze Tomoyuki, Kasai Michi, Mochizuki Kyoko, Aoki Shigeru, Miyagi Etsuko, Nagase Hiromi, Ishikawa Hiroshi
Аннотация
AIM: To identify congenital pulmonary airway malformation (CPAM) volume ratio (CVR) values that can predict the need for early neonatal surgery.
METHODS: We retrospectively reviewed 70 infants diagnosed with congenital cystic lung diseases (CCLD) over the past 10 years at our center (10 with CPAM, 25 with intra- and extra-lobar bronchopulmonary sequestrations, and 35 with bronchial atresia). Perinatal features, the maximum CVR during pregnancy, and the final CVR before delivery were compared between the early surgery group (surgery within 1 week of birth) and the follow-up group (surgery after 1 week of birth or no surgery).
RESULTS: Among all fetuses with CCLD, the median maximum and final CVR values were 1.2 (interquartile range [IQR]: 0.7-1.9) and 0.5 (IQR: 0.2-0.9) with a median gestational age of 26 weeks (IQR: 24-30) and 34 weeks (IQR: 32-37), respectively. Early neonatal surgery was required in nine infants (five with CPAM, one with bronchopulmonary sequestrations, and three with bronchial atresia). Compared to the follow-up groups, patients in the early surgery group had higher maximum CVR, higher final CVR, and a greater incidence of polyhydramnios. The maximum and final CVR thresholds of 1.86 and 0.9, yielded sensitivity of 78% and 78% and specificity of 80% and 85%, respectively. The areas under the curve for the maximum and final CVR values were 0.85 and 0.88, respectively.
CONCLUSION: A maximum CVR threshold of 1.86 and a final CVR threshold of 0.9 may be useful indicators for predicting the need for early neonatal surgery.
METHODS: We retrospectively reviewed 70 infants diagnosed with congenital cystic lung diseases (CCLD) over the past 10 years at our center (10 with CPAM, 25 with intra- and extra-lobar bronchopulmonary sequestrations, and 35 with bronchial atresia). Perinatal features, the maximum CVR during pregnancy, and the final CVR before delivery were compared between the early surgery group (surgery within 1 week of birth) and the follow-up group (surgery after 1 week of birth or no surgery).
RESULTS: Among all fetuses with CCLD, the median maximum and final CVR values were 1.2 (interquartile range [IQR]: 0.7-1.9) and 0.5 (IQR: 0.2-0.9) with a median gestational age of 26 weeks (IQR: 24-30) and 34 weeks (IQR: 32-37), respectively. Early neonatal surgery was required in nine infants (five with CPAM, one with bronchopulmonary sequestrations, and three with bronchial atresia). Compared to the follow-up groups, patients in the early surgery group had higher maximum CVR, higher final CVR, and a greater incidence of polyhydramnios. The maximum and final CVR thresholds of 1.86 and 0.9, yielded sensitivity of 78% and 78% and specificity of 80% and 85%, respectively. The areas under the curve for the maximum and final CVR values were 0.85 and 0.88, respectively.
CONCLUSION: A maximum CVR threshold of 1.86 and a final CVR threshold of 0.9 may be useful indicators for predicting the need for early neonatal surgery.