• Rodrigo Ruano, Paula Beatriz Tavares Fettback, Vinicius Lima Ribeiro, Marcus Marques Silva, João Gilberto Maksoud, and Marcelo Zugaib.
• Department of Obstetrics, Fetal Medicine Unit, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil. rodrigoruano@usp.br
• Sao Paulo Med J. 2008 Jul 1; 126 (4): 239241239-41.

ContextMacrocystic adenomatoid malformation of the lung can cause severe mediastinal shift, hydrops and polyhydramnios, thereby increasing the risk of perinatal deaths. After 33 weeks of gestation, repeated puncturing of the cyst is recommended. We present a case in which a cyst-amniotic shunt was placed instead of performing this procedure.Case ReportA cyst-amniotic shunt was placed at 33 weeks of gestation because of a large macrocystic adenomatoid malformation of the lung associated with severe mediastinal shift and polyhydramnios. Although it was confirmed that the catheter was in the correct place, the cyst increased in size again two weeks later, associated with repetition of polyhydramnios. It was postulated that the catheter was blocked, and we chose to place another catheter instead of performing repeated punctures. The cystic volume, polyhydramnios and mediastinal shift regressed progressively. At 38.5 weeks, a 3,310/g male infant was delivered without presenting any respiratory distress. The infant underwent thoracotomy on the 15th day of life. Thus, in the present study, we discuss the possibility of placing a cyst-amniotic shunt instead of performing repeated cystic punctures, even at a gestational age close to full term.

20 keywords...

hide…