[Lung hypoplasia: an underestimated diagnosis?].

BACKGROUND

Lung hypoplasia is a complex disease which is probably an underestimated problem in newborns. The diagnosis may be missed since the clinical features are highly varying. Histologic counting of alveoli is necessary to ensure the diagnosis.

PATHOGENESIS: Risk factors for lung hypoplasia are oligohydramnios, absent fetal breathing movements, and thoracal tumors. Under these conditions physical stimuli are absent on which lung growth mainly depends. In the case of preterm rupture of membranes the gestational age and the degree of oligohydramnios are decisive for the risk of hypoplasia. Postnatal growth can compensate in less severe cases. However, in severe cases persistent pulmonary hypertension is associated with a poor outcome. THERAPY AND DIAGNOSIS: New therapeutic options for persistent pulmonary hypertension are currently under evaluation. Prenatal measurement of lung volume and flow profile in pulmonary vessels are new issues to improve prenatal diagnosis.

CONCLUSIONS

Lung hypoplasia is usually not adequately taken into account. High clinical suspicion is necessary in order to understand this disease and to develop therapeutic strategies.