Perinatal Management of High-Risk Congenital Lung Malformations: A Multicenter Analysis.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gurrala Rakesh Reddy, Ray Marissa A, Stanic Philip, Wunker Claire, Heitsman Cecilia Gigena, Pena Deion, Larson Abby C, Bertaux Nicole J, Halbert-Elliott Kyra, Stewart Latoya A, Jean-Pierre Tayana, Park Jooyoung, Vaughn Cortnie R, Buchmiller Terry L, Calkins Casey M, Carr Benjamin D, Cass Darrell L, Church Joseph T, Derderian S Christopher, Duron Vincent P, Fenton Stephen J, Ferrantella Anthony Raymond, Gray Brian W, Greco Patricia S, Kim Aimee G, Maloney Caroline, Robertson Jason O, Rymeski Beth, Snyder Christopher W, Sun Raphael C, Vrecenak Jesse D, Yu Peter T, Zamora Irving J, Kunisaki Shaun M, Lobeck Inna N, Congenital Lung Malformation Study Group
Аннотация
METHODS: Retrospective analysis of prenatally diagnosed CLMs (2016-2024) from a 17-center consortium was performed. Prenatal characteristics, procedural details, and outcomes were analyzed for patients undergoing ex utero intrapartum treatment (EXIT), cesarean section-to-immediate resection (STR), or emergent resection within 24 hours of birth (ER).
RESULTS: Of 1756 CLM patients, 25 (1.4%) underwent perinatal intervention: 15 EXIT (0.9%), 4 STR (0.2%), and 6 ER (0.3%). Among EXIT cases, 11 (73%) underwent EXIT-to-resection and 4 (27%) EXIT-to-airway. Most lesions were large, with a median congenital pulmonary airway malformation volume ratio (CVR) at delivery of 2.3 (IQR 1.57-2.70). Mediastinal shift was universal (100%), while hydrops was present in 33%. Congenital pulmonary airway malformation (CPAM) was the most common pathology-based diagnosis among EXIT patients (87%). Procedural survival was 15/15 (100%) for EXIT, 4/4 (100%) for STR, and 5/6 (83%) for ER. Thirty-day survival was 13/15 (87%) for EXIT, 4/4 for STR, and 3/6 for ER. ECMO was used in 2/15 EXIT, 1/4 STR, and 1/6 ER neonates. Median NICU length of stay for survivors was 30 days (EXIT), 24 days (STR), and 25 days (ER).
CONCLUSION: Perinatal intervention for CLM remains rare. These findings provide contemporary multicenter data on EXIT, STR, and ER and may help inform prenatal counseling and delivery planning. Further study is warranted to refine patient selection for perinatal intervention and delivery modification.