Pulmonary sequestrations vary in size at presentation and can change throughout the pregnancy. The diagnosis is made by prenatal ultrasonographic findings of an echogenic (bright) mass appearing in the chest of the fetus. The mass may displace the heart from its normal position or push the diaphragm downward, but the key feature of a sequestration is the finding of an artery leading from the cystic mass directly to the aorta. This is what distinguishes a pulmonary sequestration from a CCAM.
The majority of these fetuses have a very good outcome. Pulmonary sequestrations remain the same size or grow with the fetus, but usually do not cause severe problems, probably because there remains enough room for the normal part of the lung to grow. The mass may shrink in size before birth. In all these cases, the outlook for a normal life is excellent. These fetuses should be followed closely, delivered near term, and the pulmonary sequestration removed surgically after birth.
Those who do not have hydrops when the lesion is first detected must be closely followed by doing ultrasounds at least every week to look for the development of hydrops. If they do not develop hydrops, we continue a “wait-and-see” attitude with close follow-up. Many of these lesions will begin to decrease in size before 26 weeks of gestation and almost all can be safely dealt with after birth at a tertiary perinatal center. Some lesions will even take care of themselves entirely.
A small number of fetuses with pulmonary sequestrations may develop large pleural effusions (excess fluid in the chest cavity) and even signs of heart failure (hydrops). Unlike CCAM that cause trouble by virtue of their size, pulmonary sequestrations cause trouble by virtue of the high blood flow through the tumor. These are the only fetuses who require treatment before birth.
PLEASE CONTINUE TO PRAY!
* here are a few pictures of her. Our Doctor said that she was playing with her hair, but I think she likes the feeling of her bald head! The first one is her peace sign . . surprised that we could see her tiny little fingers because she's usually making a fist!
1 comment:
Our God is good and has provided for us sooooo well, Isabell continues to be in His care!!!
Isnt she beautiful???!!
Cant wait to hold her tight, but I WILL wait. Keep on cooking.
Nana
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