Complete resolution of hydrops by placement of double basket catheter in a case of macrocystic type multilocular pulmonary sequestration

Abstract

Objective: We presented a fetus affected by macrocystic lung lesions with progressive hydropic changes during the second trimester, but experienced remarkable resolution of hydrops in the third trimester after a series of in utero interventions. Case report: A 19-year-old women, G1P0, presented with fetal multilocular thoracic mass and hydropic change at 23+4 weeks of gestation. After non-directive genetic counseling, she opted for intrauterine cyst aspiration followed by intra-cystic OK-432 injection at 24 weeks of pregnancy, as well as sequential thoracoamniotic shunts at 26 weeks and 27+3 weeks of pregnancy when we observed hydrops developed progressively. Finally, the hydrops resolved in the third trimester and a healthy baby was born at 33+3 weeks of pregnancy, in which further surgical intervention was performed at five-month old. Conclusion: Thoracoamniotic shunting is a preferred option for all hydropic fetuses resulted from large macrocystic lung lesions to enhance perinatal survival rate.

Keywords

• Congenital lung cyst
• Macrocystic lung lesions
• Hydrops fetalis
• Prenatal intervention
• Thoracoamniotic shunts