Laryngeal atresia
- Atresia = obstruction.
- As a results from failure of the laryngeal lumen to recanalize.
- Congenital or acquired narrowing of the airway that may affect the supraglottis, glottis, and/or subglottis
- Features:
2) Dilated airways below the obstruction
3) Enlarged lung and echogenic (due to
accumulation of fluid)
4) Flattened or inverted diaphragm
5) Fetal ascites
6) Edema
Figure 11. Laryngeal atresia. Available athttp://www.sonoworld.com/fetus/page.aspx?id=1250
Tracheoesophageal fistula (TEF)
contents enter trachea through fistula) 3) edema |
Respiratory distress syndrome (RDS)
- 2% of live newborn mostly premature baby,
- Cause by:
2) lungs unable to inflate and alveoli contain fluid
with a high protein
- Clinical presentations:
2) tachypnea
Figure 13. Respiratory distress syndrome. Available at http://drugline.org/ail/pathography/1572/
LUNG HYPOPLASIA
- Characterized by incomplete development of lung tissue
- Consists of:
2) malformed bronchial stump
3) absent or poorly differentiated distal lung tissue
- > than 50% associates with coexisting cardiac, GI, genitourinary, and skeletal malformations
- Clinical presentations:
- May be asymptomatic or may present with severe respiratory distress or
- Apnea that requires extensive ventilatory support
- Older children, dyspnea and cyanosis may be present upon exertion, or has repeated history of respiratory infections
- The external chest may appear normal or may be small and bell shaped, with or without scoliosis.
- A mediastinal shift is observed toward the involved side, and dullness upon percussion is heard over the displaced heart.
- In right-sided hypoplasia, the heart is displaced to the right, which may lead to a mistaken diagnosis of dextrocardia
- Breath sounds may be decreased or absent on the side of hypoplasia, especially over the bases and axilla
- Pneumothorax, spontaneous or associated with mechanical ventilation, may occur
- Compression deformities due to prolonged oligohydramnios, contractures, and arthrogryposis may be present
- The Potter facies (hypertelorism, epicanthus, retrognathia, depressed nasal bridge, low set ears) suggest lung hypoplasia caused by the associated renal defects
- When the etiology of the hypoplasia is a neuromuscular disease, the patient may have myopathic facies, with a V-shaped mouth, muscle weakness, and growth retardation