(bright music)
- When a chest mass has been
identified in ultrasound
that falls into the category
of the congenital pulmonary
airway malformations,
we look very closely on the ultrasound
for any other anomalies
that may be present.
For most of these kids,
this is an isolated finding
and not related to any other
problems with the baby.
For kids who do have a CPAM
or the congenital pulmonary
airway malformation,
we follow them very closely
once it's been identified.
We know that the size of this lesion
or this mass correlates with the risk
of the baby developing
heart failure or hydrops,
which is extra fluid in
extra spaces in the body,
extra fluid around the heart,
extra fluid around the lungs,
extra fluid in the belly or in the skin.
So we can follow babies closely
to see if there's any signs
of hydrops or heart failure
with the ultrasound.
Traditionally, patients can be categorized
as being at a high risk for hydrops
or a low risk for hydrops
based on the size of the mass
or what we call the CVR,
which is a relationship
of the size of the mass
to the actual head
circumference of the baby,
a way to kind of indicate
how large this mass is relative to the,
or proportionally to the rest of the baby.
For kids who have a relatively
low risk of hydrops,
we do continue to follow
them every two weeks,
spacing out the intervals
as the kid gets farther
along in gestation.
Most of these masses may continue to grow
up until 28 to 32 weeks.
So this close surveillance
needs to continue
throughout most of the pregnancy.
For kids who have a very large size mass
and are at an increased risk of hydrops,
we actually will follow them weekly.
And there are some kids where
the size of the mass puts them
at such high risk of hydrops,
or we may even see early signs of hydrops
that we can consider therapy or treatment
that has been shown to
reverse the process.
