Venous arterialization in extralobar pulmonary sequestration associated with fetal hydrops

Journal of Pediatric Surgery
Yoshihiro KitanoHaruhiko Sago

Abstract

Fetal extralobar pulmonary sequestration (EPS) is sometimes complicated by massive pleural effusion (PE) leading to fetal hydrops. The underlying mechanisms as well as the origin of the fluid are not well understood. This study was performed to find a histological hallmark of an EPS with massive PE. We hypothesized that venous obstruction has a role to play in the mechanisms of fluid production by EPS. We recently experienced 3 cases of fetal EPS complicated by fetal hydrothorax requiring thoracentesis and eventually thoracoamniotic shunt placement. Total protein content and cell count were measured in the aspirates, which were compared with chylothorax cases (n = 5) requiring fetal shunt placement. After birth, all 3 infants required mass resection for the control of PE. The venous wall thickness was measured on pathology slides stained with Elastica van Gieson staining. Thickness of the media and adventitia was measured in approximately 40 veins per case. They were corrected by external diameter and expressed as percentage of medial thickness and percentage of adventitial thickness. An EPS not associated with PE but with congenital diaphragmatic hernia served as a control. Total protein and the cell count of the EPS related P...Continue Reading

References

Oct 28, 1998·American Journal of Obstetrics and Gynecology·N S AdzickL J Howell
Feb 2, 2000·The Annals of Thoracic Surgery·M EndoK Tabayashi
Aug 10, 2002·Pediatric Cardiology·M EndoK Tabayashi
Dec 20, 2002·Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft·Katsushi KawaiKodo Kodama
Mar 28, 2003·American Journal of Perinatology·Patrice MorvilleGhassan Harika

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Citations

Feb 1, 2008·Archives of Gynecology and Obstetrics·Gökhan YildirimYavuz Ceylan
Oct 29, 2008·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·P CavorettoK H Nicolaides
Jun 27, 2009·Journal of Perinatology : Official Journal of the California Perinatal Association·T E Herman, M J Siegel
Apr 18, 2008·Fetal Diagnosis and Therapy·Yoshihiro KitanoNobuyuki Morikawa

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