Postnatal chest wall deformities after fetal thoracoamniotic shunting for congenital cystic adenomatoid malformation

Aziz M. Merchant, William Peranteau, R. Douglas Wilson, Mark P. Johnson, Michael W. Bebbington, Holly L. Hedrick, Alan W. Flake, N. Scott Adzick

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Objectives: Large macrocystic congenital cystic adenomatoid malformations (CCAMs) can be treated with thoracoamniotic (TA) shunting to reduce CCAM volume. Two CCAM fetuses treated with TA shunt had postnatal radiographic rib deformities. Study Design: Retrospective review of prenatal TA shunting for large macrocystic CCAMs evaluated for the presence of rib deformities. Comparison groups not eligible for TA shunting included nonshunted CCAMs resected postnatally (group A) and size-matched nonshunted CCAMs resected postnatally (group B). Results: Chest wall abnormalities were identified in 77% of newborns ranging from severe concavity and fractures (in two fetuses shunted at 18 and 20 weeks of gestation) to rib thinning compared to comparison groups A and B. The severity of chest wall deformity correlated with earlier gestational age at shunting. Conclusions: TA shunting at less than 21 weeks of gestational age may result in postnatal chest wall deformity. This observation should be discussed during counseling for this procedure.

Original languageEnglish (US)
Pages (from-to)435-439
Number of pages5
JournalFetal Diagnosis and Therapy
Issue number6
StatePublished - Oct 2007
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology


  • Macrocystic congenital cystic adenomatoid malformations
  • Rib deformity
  • Thoracoamniotic shunting


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