Objective: The purpose of this study is to identify the pregnancy outcome and the predictors for an adverse outcome of antenatally diagnosed congenital cystic adenomatoid malformation (CCAM).
Methods: Between December 1998 and April 2009, 157 patients antenatally diagnosed with CCAM were studied retrospectively.
We evaluated respiratory symptoms, surgery, ventilator use as outcome. These were analyzed using SPSS 14.0.
Results: The mean gestational age at diagnosis was 23.5±3.4 weeks. Chromosomal study was performed in 44 fetuses, and no abnormalities were detected in any of them. Combined anomalies were found in 8(12.7%) fetuses. The rate of presence of hydrops and/or polyhydramnios was 9 (14.3%). The timing of the regression in size was a mean of 30.6±3.8 weeks, and typeIII had the highest rate of spontaneous regression. Sixty-three fetuses were born alive. The average length of their hospital stays was 8.2±9.1 days (2~210 days) and the mean length of their ICU stays was 4.8±10.3 days (0~69). Thirty-two patients (50.8%) underwent lobectomy. There was a significant correlation between the outcomes and polyhydramnios, mass type, maximal diameter of the mass at diagnosis, and the maximal diameter of the mass at delivery according to the fetal ultrasound findings. Cut-off values of maximal diameter of the mass at diagnosis, and the maximal diameter of the mass at delivery derived from receiver-operating characteristic curves yielding the best sensitivity and specificity for perinatal outcome were ≥ 40 mm.
Conclusion: These findings have important implications for prenatal counselings, and for predicting the perinatal outcome of CCAM.