EP07.79: The contribution of ultrasound to the prenatal diagnosis of adenomatoid cystic malformations of the lung

Abstract

Antenatal ultrasound has revolutionised the detection of congenital lung malformations, such as adenomatoid cystic malformations (ACML), which are characterised by abnormal bronchial tissue growth. Prognosis often hinges on the remaining healthy lung volume, with a tendency towards favourable spontaneous evolution. We present a case where ACML was identified during a fifth-month ultrasound in a 25-year-old primigravida with no significant medical history but second-degree consanguinity. At 22 weeks, a morphological ultrasound revealed cystic formations in the left lung, the largest being 16mm, along with dextrocardia and mediastinal deviation, classified as ACML type 1. The right lung and diaphragm appeared normal, with typical levels of amniotic fluid and no associated anomalies or signs of compression. Financial constraints rendered fetal MRI impractical, leading to continued ultrasound monitoring. Delivery occurred at a level three maternity hospital, with no typical disappearance of ultrasound images in the third trimester. Though rare, hydrops can pose a serious threat to fetal life, necessitating swift intervention. Treatment involves addressing isolated, compressive MAKP with a cysto-amniotic bypass drain, offering a nearly 70% survival rate. The newborn was delivered at term without respiratory support but developed recurrent lower respiratory infections, resulting in two hospitalisations. Surgical intervention was postponed due to the child's young age. Advancements in antenatal ultrasound have enabled the early detection of congenital lung malformations, facilitating prompt treatment and the prevention of complications. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.