Focus area: Physicians
Natural prenatal history of congenital pulmonary malformations: the MALFPULM population-based cohort study
The aims of the study were: 1) to assess prenatal changes in the volume of CPM and to examine whether these changes were different for cystic vs. hyperechoic lesions and 2) to study the relation between volume of CPM and risk of fetal compression.
A nationally representative, multi-center prospective cohort study was conducted and 579 ultrasound exams from 176 pregnant women were included.
Cystic/mixed CPM were characterized by a monotonic decrease in CVR with increasing gestational age (p=0.002) whereas hyperechoic CPM showed an initial increase in CVR up to 27 weeks of gestation, followed by a decrease thereafter (p<0.001). Fetuses that showed no sign of compression had substantially lower CVR at diagnosis, and the CVR remained relatively constant thereafter. Specifically, for fetuses with no sign of compression at diagnosis, the odd of a subsequent compression was 7-fold higher (Adjusted OR 7.0; 95% CI 1.6-29.9) when CVR was > 0.4 vs CVR ≤ 0.4 cm2.
As expected, cystic and hyperechoic malformations have different pattern of volumetric changes. Size of the CVR measured at the initial, diagnostic ultrasound was highly associated with the odds of a subsequent compression
Delacourt C, Bertille N, Salomon LJ, Benachi A, Henry E, Massardier J, Mottet N, Rosenblatt J, Sartor A, Thong-Vanh C, Valat-Rigot AS, Winer N, Lelong N, Khoshnood B; prenatal MALFPULM study group. Natural prenatal history of congenital pulmonary malformations: the MALFPULM population-based cohort study. Ultrasound Obstet Gynecol. 2018 Sep 27. doi: 10.1002/uog.20130.