Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-26T09:05:48.736Z Has data issue: false hasContentIssue false

Chapter 15.2 - Fetal lung growth, development, and lung fluid

Clinical management of pleural effusion and pulmonary pathology

from Section 2 - Fetal disease

Published online by Cambridge University Press:  05 February 2013

By
Kirsten Grabowska  and
R. Douglas Wilson
Edited by
Mark D. Kilby ,
Anthony Johnson  and
Dick Oepkes
Mark D. Kilby
Affiliation:
Department of Fetal Medicine, University of Birmingham
Anthony Johnson
Affiliation:
Baylor College of Medicine, Texas
Dick Oepkes
Affiliation:
Department of Obstetrics, Leiden University Medical Center
Get access

Summary

Introduction

Primary fetal lung and airway anomalies are rare. With improvements in ultrasound, our understanding of both the underlying pathology and natural history has improved over the past two decades. With the improved surveillance and advances in fetal therapy, there have been significant improvements in perinatal survival. The following section presents a review of the most common pulmonary pathologies, including fetal pleural effusions (FPE), pulmonary adenomatoid malformations, and CHAOS (congenital high airway obstruction sequence). The antenatal management, with particular focus on prognostic features and indications for intervention, is described. The evidence-based methods of fetal therapy, and available data on fetal and neonatal outcome following antenatal intervention are reviewed.

Incidence, etiology, associated features, and natural history

FPE is a condition with identified fluid collections in the pleural spaces of the fetal thorax. Primary FPE (chylothorax) is the accumulation of lymphatic fluid in the pleural space. Secondary FPE result from the collection of serous fluid in the pleural cavity. Secondary FPE can be caused by congenital infection, aneuploidy, and congenital defects, including cardiac defects, pulmonary adenomatoid malformations, and congenital diaphragmatic hernia (CDH). In fetal hydrops due to severe anemia, FPE is rarely seen.

Keywords

pulmonary adenomatoid malformationscongenital pulmonary airway malformationfetal pleural effusionsfetal therapycongenital high airway obstruction sequencebronchopulmonary sequestrationcongenital cystic adenomatoid malformations
Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
 , pp. 282 - 300
Publisher: Cambridge University Press
Print publication year: 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Longaker, MT, Laberge, JM, Dansereau, J, et al. Primary fetal hydrothorax: natural history and management. J Pediatr Surg 1989;24:573–6.Google Scholar
Hagay, Z, Reece, A, Roberts, A, Hobbins, JC. Isolated fetal pleural effusion: a prenatal management dilemma. Obstet Gynecol 1993;81:147–52.Google Scholar
Aubard, Y, Derouineau, I, Aubard, V, Chalifour, V, Preux, PM. Primary fetal hydrothorax: a literature review and proposed antenatal clinical strategy. Fetal Diagn Ther 1998;13:325–33.Google Scholar
Noonan, JA, Walters, LR, Reeves, JT. Congenital pulmonary lymphangiectasis. Am J Dis Child 1970;120:314–19.Google Scholar
Wilson, RD, Pawel, B, Bebbington, M, et al. Congenital pulmonary lymphangiectasis sequence: a rare, heterogeneous, and lethal etiology for prenatal pleural effusion. Prenat Diagn 2006;26:1058–61.Google Scholar
Yinon, Y, Grisaru-Granovsky, S, Chaddha, V, et al. Perinatal outcome following fetal chest shunt insertion for pleural effusion. Ultrasound Obstet Gynecol 2010;36:58–64.Google Scholar
Klam, S, Bigras, JL, Hudon, L. Predicting outcome in primary fetal hydrothorax. Fetal Diagn Ther 2005;20:366–70.Google Scholar
Rustico, MA, Lanna, M, Coviello, D, Smoleniec, J, Nicolini, U. Fetal pleural effusion. Prenat Diagn 2007;27:793–9.Google Scholar
Smith, RP, Illanes, S, Denbow, ML, Soothill, PW. Outcome of fetal pleural effusions treated by thoracoamniotic shunting. Ultrasound Obstet Gynecol 2005;26:63–6.Google Scholar
Devine, PC, Malone, FD. Noncardiac thoracic anomalies. Clin Perinatol 2000;27:865–99.Google Scholar
Johnson, MP. Fetal shunt procedures. In: Evans, MI, Johnson, MP, Moghissi, KS, eds. Invasive Outpatient Procedures in Reproductive Medicine. Philadelphia, Lippincott-Raven Publishers. 1997; 61–90.
Wilson, RD, Johnson, MP. Prenatal ultrasound guided percutaneous shunts for obstructive uropathy and thoracic disease. Semin Pediatr Surg 2003;12:182–9.Google Scholar
Mandelbrot, L, Dommergues, M, Aubry, MC, Mussat, P, Dumez, Y. Reversal of fetal distress by emergency in utero decompression of hydrothorax. Am J Obstet Gynecol 1992;167:1278–83.Google Scholar
Gonen, R, Degani, S, Kugelman, A, Abend, M, Bader, D. Intrapartum drainage of fetal pleural effusion. Prenat Diagn 1999;19:1124–6.Google Scholar
Rodeck, CH, Fisk, NM, Fraser, DI, Nicolini, U. Long-term in utero drainage of fetal hydrothorax. N Engl J Med 1988;319:1135–8.Google Scholar
Nicolaides, KH, Azar, GB. Thoraco-amniotic shunting. Fetal Diagn Ther; 1990;5:153–64.Google Scholar
Bernaschek, G, Deutinger, J, Hansmann, M, et al. Feto-amniotic shunting – report of the experience of four European centres. Prenat Diagn 1994;14:821–33.Google Scholar
Picone, O, Benachi, A, Mandelbrot, L, et al. Thoracoamniotic shunting for fetal pleural effusions with hydrops. Am J Obstet Gynecol 2004;191:2047–50.Google Scholar
Caserio, S, Gallego, C, Martin, P, et al. Congenital chylothorax: from foetal life to adolescence. Acta Paediatr 2010;99:1571–7.Google Scholar
Deurloo, KL, Devlieger, R, Lopriore, E, Klumper, FJ, Oepkes, D. Isolated fetal hydrothorax with hydrops: a systematic review of prenatal treatment options. Prenat Diagn 2007;27:893–9.Google Scholar
Brown, R, Nicolaides, K. Constriction band of the arm following insertion of a pleuro-amniotic shunt. Ultrasound Obstet Gynecol 2000;15:439–40.Google Scholar
Chen, M, Shih, JC, Wang, BT, Chen, CP, Yu, CL. Fetal OK-432 pleurodesis: complete or incomplete? Ultrasound Obstet Gynecol 2005;26:791–3.
Tanemura, M, Nishikawa, N, Kojima, K, Suzuki, Y, Suzumori, K. A case of successful fetal therapy for congenital chylothorax by intrapleural injection of OK-432. Ultrasound Obstet Gynecol 2001;18:371–5.Google Scholar
Okawa, T, Takano, Y, Fujimori, K, Yanagida, K, Sato, A. A new fetal therapy for chylothorax: pleurodesis with OK-432. Ultrasound Obstet Gynecol 2001;18:376–7.Google Scholar
Jorgensen, C, Brocks, V, Bang, J, Jorgensen, FS, Rønsbro, L. Treatment of severe fetal chylothorax associated with pronounced hydrops with intrapleural injection of OK-432. Ultrasound Obstet Gynecol 2003;21:66–9.Google Scholar
Tsukihara, A, Tanemura, M, Suzuki, Y, et al. Reduction of fetal pleural effusion by OK-432 in a fetus complicated with congenital hydrothorax. Fetal Diagn Ther 2004;19:327–31.Google Scholar
Yang, YS, Ma, GC, Shih, JC, et al. Experimental treatment of bilateral fetal chylothorax using in utero pleurodesis. Ultrasound Obstet Gynecol 2012;39:56–62.Google Scholar
Bennet, L, Cowie, RV, Stone, PR, et al. The neural and vascular effects of killed Su-Streptococcus pyogenes (OK-432) in preterm fetal sheep. Am J Physiol Regul Integr Comp Physiol 2010;299:R664–72.Google Scholar
Cowie, RV, Stone, PR, Parry, E, et al. Acute behavioral effects of intrapleural OK-432 (Picibanil) administration in preterm fetal sheep. Fetal Diagn Ther 2009;25:304–13.Google Scholar
Cass, DL, Crombleholme, TM, Howell, LJ, et al. Cystic lung lesions with systemic arterial blood supply: a hybrid of congenital cystic adenomatous malformation and bronchopulmonary sequestration. J Pediatr Surg 1997;32:986–90.Google Scholar
Leninger, BJ, Haight, C. Congenital cystic adenomatoid malformation of the left lower lobe with compression of the remaining lung tissue in a newborn. Clin Pediatr 1973;12:182–6.Google Scholar
Carter, R. Pulmonary sequestration. Ann Thorac Surg 1969;7:68–88.Google Scholar
Roggin, KK, Breuer, CK, Carr, SR, et al. The unpredictable character of congenital cystic lung lesions. J Pediatr Surg 2000;35:801–5.Google Scholar
Laberge, JM, Flageole, H, Pugash, D, et al. Outcome of the prenatally diagnosed congenital cystic adenomatoid lung malformation: a Canadian experience. Fetal Diagn Ther 2001;16:178–86.Google Scholar
Gornall, AS, Budd, JLS, Draper, ES, Konje, JC, Kurinczuk, JJ. Congenital cystic adenomatoid malformation: accuracy of prenatal diagnosis, prevalence and outcome in a general population. Prenat Diagn 2003;23:997–1002.Google Scholar
Stocker, TJ, Manewell, JE, Drake, RM. Congenital cystic adenomatoid malformation of the lung: classification and morphologic spectrum. Hum Pathol 1977;8:155–71.Google Scholar
Adzick, NS, Harrison, MR, Glick, PL, et al. Fetal cystic adenomatoid malformation: prenatal diagnosis and natural history. J Pediatr Surg 1985;20:483–8.Google Scholar
Liu, YP, Chen, CP, Shi, SL, et al. Fetal cystic lung lesions: evaluation with magnetic resonance imaging. Pediatr Pulmonol 2010;45;592–600.Google Scholar
Davenport, M, Warne, SA, Cacciaguerra, S, et al. Current outcome of antenally diagnosed cystic lung disease. J Pediatr Surg 2004;39:549–56.Google Scholar
Adzick, NS, Harrison, MR, Crombleholme, TM, Flake, AW, Howell, LJ. Fetal lung lesions: management and outcome. Am J Obstet Gynecol 1998;179:884–9.Google Scholar
De Santis, M, Masini, L, Noia, G, et al. Congenital cystic adenomatoid malformation of the lung: antenatal ultrasound findings and fetal-neonatal outcome. Fetal Diagn Ther 2000;15:246–50.Google Scholar
Crombleholme, TM, Coleman, B, Hedrick, H, et al. Cystic adenomatoid malformation volume ratio predicts outcome in prenatally diagnosed cystic adenomatoid malformation of the lung. J Pediatr Surg 2002;37:331–8.Google Scholar
Cass, DL, Olutoye, OO, Cassady, CI, et al. Prenatal diagnosis and outcome of fetal lung masses. J Pediatr Surg 2011;46:292–8.Google Scholar
Parenteau, WH, Wilson, RD, Liechty, KW, et al. Effect of maternal betamethasone administration on prenatal congenital cystic adenomatoid malformation growth and fetal survival. Fetal Diagn Ther 2007;22:365–71.Google Scholar
Curran, PF, Jelin, EB, Rand, L, et al. Prenatal steroids for microcystic congenital cystic adenomatoid malformations. J Pediatr Surg 2010;45:145–50.Google Scholar
Brown, RN. Multiple steroid courses result in tumour shrinkage in congenital pulmonary airway malformation (congenital cystic adenomatoid malformation). Prenat Diagn 2009;29:989–91.Google Scholar
Wilson, RD. In utero therapy for fetal thoracic abnormalities. Prenat Diagn 2008;28:619–25.Google Scholar
Schrey, S, Kelly, EN, Langer, JC, et al. Fetal thoraco-amniotic shunting for large macrocystic congenital cystic adenomatoid malformations (CCAM) of the lung. Ultrasound Obstet Gynecol 2012;39:515–20.Google Scholar
Merchant, AM, Peranteau, W, Wilson, RD, et al. Postnatal chest wall deformities after fetal thoracoamniotic shunting for congenital cystic adenomatoid malformation. Fetal Diagn Ther 2007;22:435–9.Google Scholar
Witlox, RS, Lopriore, E, Oepkes, D. Prenatal interventions for fetal lung lesions. Prenat Diagn 2011;31:628–36.Google Scholar
Thorpe-Beeston, JG, Nicolaides, KH. Cystic adenomatoid malformation of the lung: prenatal diagnosis and outcome. Prenal Diagn 1994;14:677–88.Google Scholar
Dommergues, M, Louis-Sylvestre, C, Mandelbrot, L, et al. Congenital adenomatoid malformation of the lung: when is active fetal therapy indicated? Am J Obstet Gynecol 1997;177:953–8.Google Scholar
Morikawa, M, Yamada, H, Okuyama, K, et al. Prenatal diagnosis and fetal therapy of congenital cystic adenomatoid malformation type I of the lung: a report of five cases. Congenit Anom (Kyoto) 2003;43:72–8.Google Scholar
Wilson, RD, Baxter, JK, Johnson, MP, et al. Thoracoamniotic shunts: fetal treatment of pleural effusions and congenital cystic adenomatoid malformations. Fetal Diagn Ther 2004;19:413–20.Google Scholar
Illanes, S, Hunter, A, Evans, M, Cusick, E, Soothill, P. Prenatal diagnosis of echogenic lung: evolution and outcome. Ultrasound Obstet Gynecol 2005;26:145–9.Google Scholar
Ierullo, AM, Ganapathy, R, Crowley, S, et al. Neonatal outcome of antenatally diagnosed congenital cystic adenomatoid malformations. Ultrasound Obstet Gynecol 2005;26:150–3.Google Scholar
Cavoretto, P, Molina, F, Poggi, S, Davenport, M, Nicolaides, KH. Prenatal diagnosis and outcome of echogenic fetal lung lesions. Ultrasound Obstet Gynecol 2008;32:769–83.Google Scholar
Ryan, G, Oepkes, D, Langer, J, et al. Ultrasound-guided laser treatment of hydropic fetal lung lesions with a systemic arterial supply. Am J Obstet Gynecol 2003;189:S230.Google Scholar
Ruano, R, Benachi, A, Aubry, MC, et al. Prenatal diagnosis of pulmonary sequestration using three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol 2005;25:128–33.Google Scholar
Oepkes, D, Devlieger, R, Lopriore, E, Klumper, FJCM. Successful ultrasound-guided laser treatment of fetal hydrops caused by pulmonary sequestration. Ultrasound Obstet Gynecol 2007;29:457–9.Google Scholar
Witlox, RS, Lopriore, E, Walther, FJ, et al. Single-needle laser treatment with drainage of hydrothorax in fetal bronchopulmonary sequestration with hydrops. Ultrasound Obstet Gynecol 2009;34:355–7.Google Scholar
Fortunato, SJ, Lombardi, SJ, Daniell, JF, Ismael, S. Intrauterine laser ablation of a fetal cystic adenomatoid malformation with hydrops: the application of minimally invasive surgical techniques to fetal surgery. Am J Obstet Gynecol 1997;176:S84.Google Scholar
Bruner, JP, Jarnagin, BK, Reinisch, L. Percutaneous laser ablation of fetal congenital cystic adenomatoid malformation: too little, too late? Fetal Diagn Ther 2000;15:359–63.Google Scholar
Ong, SSC, Chan, SY, Ewer, AK, et al. Laser ablation of foetal microcystic lung lesion: successful outcome and rationale for its use. Fetal Diagn Ther 2006;21:471–4.Google Scholar
Milner, R, Kitano, Y, Olutoye, O, Flake, AW, Adzick, NS. Radiofrequency thermal ablation: a potential treatment for hydropic fetuses with a large chest mass. J Pediatr Surg 2000;35:386–9.Google Scholar
Vu, L, Tsao, KJ, Lee, H, et al. Characteristics of congenital cystic adenomatoid malformations associated with nonimmune hydrops and outcome. J Pediatr Surg 2007;42:1351–6.Google Scholar
Bermudez, C, Perez-Wulff, J, Arcadipane, M, et al. Percutaneous fetal sclerotherapy for congenital cystic adenomatoid malformation of the lung. Fetal Diagn Ther 2008;24:237–40.Google Scholar
Bermudez, C, Perez-Wulff, J, Bufalino, G, et al. Percutaneous ultrasound-guided sclerotherapy for complicated fetal intralobar bronchopulmonary sequestration. Ultrasound Obstet Gynecol 2007;29:586–9.Google Scholar
Grethel, EJ, Wagner, AJ, Clifton, MS, et al. Fetal intervention for mass lesions and hydrops improves outcome: a 15-year experience. J Pediatr Surg 2007;42:117–23.Google Scholar
Adzick, NS, Thom, EA, Spong, CY, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med 2011;364:993–1004.Google Scholar
Adzick, NS, Harrison, MR, Flake, AW, et al. Fetal surgery for cystic adenomatoid malformation of the lung. J Pediatr Surg 1993;28:806–12.Google Scholar
Adzick, NS. Management of fetal lung lesions. Clin Perinatol 2009;36:363–76.Google Scholar
Rychik, J, Tian, Z, Cohen, MS, et al. Acute cardiovascular effects of fetal surgery in the human. Circulation 2004;110:1549–56.Google Scholar
Wilson, RD, Johnson, MP, Crombleholme, TM, et al. Chorioamniotic membrane separation following open fetal surgery: pregnancy outcome. Fetal Diagn Ther 2003;18:314–20.Google Scholar
Wilson, RD, Johnson, MP, Flake, AW, et al. Reproductive outcomes after pregnancy complicated by maternal-fetal surgery. Am J Obstet Gynecol 2004;191:1430–6.Google Scholar
Hedrick, HL, Flake, AW, Crombleholme, TM, et al. The ex utero intrapartum therapy procedure for high risk fetal lung lesions. J Pediatr Surg 2005;40:1038–44.Google Scholar
Miniati, DN, Chintagumpala, M, Langston, C, et al. Prenatal presentation and outcome of children with pleuropulmonary blastoma. J Pediatr Surg 2006;41:66–71.Google Scholar
Murphy, JJ, Blair, GK, Fraser, GC, et al. Rhabdomyosarcoma arising within congenital pulmonary cysts: report of three cases. J Pediatr Surg 1992;27:1364–7.Google Scholar
Stanton, M, Njere, I, Ade-Ajayi, N, Patel, S, Davenport, M. Systematic review and meta-analysis of the postnatal management of congenital cystic lung lesions. J Pediatr Surg 2009;44:1027–33.Google Scholar
Hedrick, MH, Martinez-Ferro, M, Filly, RA, et al. Congenital high airway obstruction syndrome (CHAOS): a potential for perinatal intervention. J Pediatr Surg 1994;29:271–4.Google Scholar
Roybal, JL, Liechty, KW, Hedrick, HL, et al. Predicting the severity of congenital high airway obstruction syndrome. J Pediatr Surg 2010;45;1633–9.Google Scholar
Lim, FY, Crombleholme, TM, Hedrick, HL, et al. Congenital high airway obstruction syndrome: natural history and management. J Pediatr Surg 2003;38:940–5.Google Scholar
Liechty, KW, Crombleholme, TM. Management of fetal airway obstruction. Semin Perinatol 1999;23:496–506.Google Scholar
Shum, DJ, Clifton, MS, Coakley, FV, et al. Prenatal tracheal obstruction due to double aortic arch: a potential mimic of congenital high airway obstruction syndrome. AJR Am J Roentgenol 2007;188:W82–5.Google Scholar
Richards, DS, Yancey, MK, Duff, P, Stieg, FH. The perinatal management of severe laryngeal stenosis. Obstet Gynecol 1992;80:537–40.Google Scholar
Okuyama, H, Kubota, A, Kawahara, H, Oue, T, Tazuke, Y. Congenital laryngeal atresia associated with esophageal atresia and tracheoesophageal fistula: a case of long-term survival. J Pediatr Surg 2006;41:E29–32.Google Scholar
Vanhaesebrouck, P, de Coen, K, Defoort, P, et al. Evidence for autosomal dominant inheritance in prenatally diagnosed CHAOS. Eur J Pediatr 2006;165:706–8.Google Scholar
Vidaeff, AC, Szmuk, P, Mastrobattista, JM, Rowe, TF, Ghelber, O. More or less CHAOS: case report and literature review suggesting the existence of a distinct subtype of congenital high airway obstruction syndrome. Ultrasound Obstet Gynecol 2007;30:114–17.Google Scholar
Witters, I, Fryns, JP, De Catte, L, Moerman, P. Prenatal diagnosis and pulmonary pathology in congenital high airway obstruction sequence. Prenat Diagn 2009;29:1081–4.Google Scholar
Kanamori, Y, Kitano, Y, Hashizume, K, et al. A case of laryngeal atresia (congenital high airway obstruction syndrome) with chromosome 5p deletion syndrome rescued by ex utero intrapartum treatment. J Pediatr Surg 2004;39:E25–8.Google Scholar
Fokstuen, S, Bottani, A, Medeiros, PF, et al. Laryngeal atresia type III (glottis web) with 22q11.2 microdeletion: a report of three patients. Am J Med Genet 1997;70:130–3.Google Scholar
van Haelst, MM, Scambler, PJ, Fraser Syndrome Collaboration Group, Hennekam RCM. Fraser syndrome: a clinical study of 59 cases and evaluation of diagnostic criteria. Am J Med Genet A 2007;143A:3194–203.Google Scholar
Kohl, T, Hering, R, Bauriedel, G, et al. Fetoscopic and ultrasound-guided decompression of the fetal trachea in a human fetus with Fraser syndrome and congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia. Ultrasound Obstet Gynecol 2006;27:84–8.Google Scholar
Cohen, MS, Rothschild, MA, Moscoso, J, Shlasko, E. Perinatal management of unanticipated congenital laryngeal atresia. Arch Otolaryngol Head Neck Surg 1998;124:1368–71.Google Scholar
Okada, T, Ohnuma, N, Tanabe, M, et al. Long-term survival in a patient with congenital laryngeal atresia and multiple malformations. Pediatr Surg Int 1998;13:521–3.Google Scholar
Guimares, CVA, Linam, LE, Kline-Fath, BM, et al. Prenatal MRI findings of fetuses with congenital high airway obstruction sequence. Korean J Radiol 2009;10:129–34.Google Scholar
Ward, VMM, Langford, K, Morrison, G. Prenatal diagnosis of airway compromise: EXIT (ex utero intra-partum treatment) and foetal airway surgery. Int J Pediatr Otorhinolaryngol 2000;53:137–41.Google Scholar
Paek, BW, Callen, PW, Kitterman, J, et al. Successful fetal intervention for congenital high airway obstruction syndrome. Fetal Diagn Ther 2002;17:272–6.Google Scholar
Crombleholme, TM, Sylvester, K, Flake, AW, Adzick, NS. Salvage of a fetus with congenital high airway obstruction syndrome by ex utero intrapartum treatment (EXIT) procedure. Fetal Diagn Ther 2000;15:280–2.Google Scholar
Bouchard, S, Johnson, MP, Flake, AW, et al. The EXIT procedure: experience and outcome in 31 cases. J Pediatr Surg 2002;37:418–26.Google Scholar
Hedrick, HL. Ex utero intrapartum therapy. Semin Pediatr Surg 2003;12:190–5.Google Scholar
De Cou, JM, Jones, DC, Jacobs, HD, Touloukian, RJ. Successful ex utero intrapartum treatment (EXIT) procedure for congenital high airway obstruction syndrome (CHAOS) owing to laryngeal atresia. J Pediatr Surg 1998;33:1563–5.Google Scholar
Bui, TH, Grunewald, C, Frenckner, B, et al. Successful EXIT (ex utero intrapartum treatment) procedure in a fetus diagnosed prenatally with congenital high-airway obstruction syndrome due to laryngeal atresia. Eur J Pediatr Surg 2000;10:328–33.Google Scholar
Oepkes, D, Teunissen, AKK, Van de Velde, M, et al. Congenital high airway obstruction syndrome successfully managed with ex-utero intrapartum treatment. Ultrasound Obstet Gynecol 2003;22:437–9.Google Scholar
Hirose, S, Farmer, DL, Lee, H, Nobuhara, KK, Harrison, MR. The ex utero intrapartum treatment procedure: looking back at the EXIT. J Pediatr Surg 2004;39:375–80.Google Scholar
Colnaghi, M, Condo, V, Gagliardi, L, et al. Prenatal diagnosis and postnatal management of congenital laryngeal atresia in a preterm infant. Ultrasound Obstet Gynecol 2007;29:583–5.Google Scholar
Shimbabukuro, F, Sakumoto, K, Masamoto, H, et al. A case of congenital high airway obstruction syndrome managed by ex utero intrapartum treatment: case report and review of the literature. Am J Perinatol 2007;24:197–201.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×