Abstract:

A case of a pregnant woman at 24⁺⁶ weeks of pregnancy was reported. Four dimensional color ultrasound showed homogeneous hyperechogenicity of 55 mm×50 mm×45 mm in the left chest cavity of the fetus, with a tumor to head ratio of 2.63, abdominal fluid accumulation, systemic skin edema, and cardiac compression and rightward displacement. The homogeneous hyperechogenicity is fetal pulmonary sequestration. After sufficient communication and multidisciplinary consultation, ultrasound guided fetal pulmonary sequestration radiofrequency ablation was performed. Regular follow-up color ultrasound was performed after surgery, and the fetal condition gradually improved. After 46 days of surgery, color ultrasound showed a tumor to head ratio of 0.95 and no abdominal fluid or skin edema. 49 days after surgery (32 weeks of pregnancy), premature rupture of membranes occurred, and the patient was rushed to the local county hospital for emergency treatment. Regular uterine contractions occurred, and a cesarean section was performed due to emergency hip position. The newborn died 20 minutes after birth. The surgical effect of this case was ideal, but the newborn did not survive, which may be related to various factors such as small gestational week, concomitant with fetal pulmonary sequestration, and insufficient treatment with dexamethasone. Radiofrequency ablation is an effective treatment for large tumor to head ratios and with abdominal fluid, but further research is needed to confirm its safety, and postoperative management of such patients should also be strengthened.

Key words: Fetal pulmonary sequestration, Fetus, Ultrasonography, prenatal, Radiofrequency ablation, Intrauterine therapy