PERINATOLOGIYA I PEDIATRIYA.2013.3(55):5–8;doi10.15574/PP.2013.55.5

Analysis of the frequency and structure of congenital pathology of the lungs, chest and diaphragm development in fetus, identified in pregnant of the high-risk groups

Gordienko I. Yu., Tarapurova E. N., Grebinichenko A. A., Nidelchuk O. V., Veselskyi V. L., Nosko A. A.

SU «Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine», Kiev, Ukraine

Objective. To analyze the frequency and structure of congenital malformations (CM) of the lungs, chest and diaphragm of the fetus diagnosed in pregnant women of the high risk, who has sent to the Fetal Medicine Department SU «IPOG NAMS of Ukraine» for the last 11 years.

Patients and methods. The 34,787 of pregnant women from the high-risk group have been examined in the Fetal Medicine Department «IPOG NAMS of Ukraine» for 2001–2011 years. A total of 24,119 (69.3%) of primary-depth ultrasound examinations (US) and the CDF diagnosed in 3329 (13.8%) cases. According to the data was found fetal karyotype. An ultrasound performed with the use of ultrasound scanners HDI 4000 and ACCUVIX V20EX-EXP. Evaluation of the structure and frequency of pathology at the prenatal ultrasound conducted on the base of register review in accordance with the International European program EUROCAT, using a common methodology and the 5-digit code of congenital malformations ICD/BPA9.

Results. It is found that the part of the CM of the lungs, chest and diaphragm was 5.9%. The leading place in the structure of this disease took congenital diaphragmatic hernia (CDH) — 67.0% and cystic adenomatous malformation of the lungs (CAML) – 20.3%. The total share of bronchogenic cysts, pulmonary sequestration, hydrothorax, tumors and cysts of the posterior mediastinum was equal to 12.7%. CDH in 34.8 % of cases, combined with other congenital and hereditary disorders; most often experienced left-sided defect of the diaphragm. During the CAML most often (in 42.5 %) prenatally diagnosed type III pathology. 

Conclusions. The vast majority of the CM of the lungs, chest and diaphragm belong to the group of defects that are corrected but accompanied by a disability. The prognosis during this pathology is ambiguous, requires a careful examination of the fetus and newborn.

Key words: congenital malformations, ultrasound examination, prenatal diagnosis, lungs, chest, diaphragm, congenital diaphragmatic hernia, cystic adenomatous malformation of the lung development.

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