[Clinical estimation of effects of therapy thoraco-amniotic shunt method in the group of four patient with prenatal diagnosis CCAM TYP I in Polish mothers memorial hospital research institute in years 1991-2004].

OBJECTIVES: Congenital cystic adenomatoid malformation (CCAM) is a rare congenital malformation of the respiratory tract which could be diagnosed and treated prenatally. DESIGN: The aim of the retrospective assessment was to determine the efficiency of the treatment in four patients' with CCAM type I treated both prenatally and after birth in Polish Mother's Memorial Hosiptal Research Institute in years 1991-2004. MATERIALS AND METHODS: We assessed clinical course in 4 children with CCAM type I. They were diagnosed and treated prenatally in Obsteric and Gynecologic Ultrasonography Department of Polish Mother's Memorial Hospital Research Institute in years 1991-2004. Fetal examinations were performed by Accuson 128X i HDI 5000 device with a transducer 3,5 or 4 Mhz. Prenatal diagnosis was verified postnatally based on radiological examinations. RESULTS: In 4 patients prenatal diagnosis of CCAM type I was established in mean average gestational age of 23 weeks and prenatal treatment was performed in mean average gestational age of 30 weeks. Postnatally children had surgical treatment in average age of 14 day of life. In follow-up of these children (average 2 years) normal psycho-physical development (according to the Denver scale assessment) was found and there had not been shown any significant deviations in circulatory system (based on echocardiography). CONCLUSIONS: 1. CCAM type I should be diagnosed prenatally in obstetrical ultrasonographic examinations and than referred to the Perinatal Reference Centre in the aim of the further complex medical care. 2. In some cases of the CCAM type I successful "in utero" treatment can be attempted by thoraco-amniotic shunt which protects complications development, especially when the fetal circulatory system assessment is positive.