Prenatal diagnosis of main stem bronchial atresia using 3-dimensional ultrasonographic technologies

Objective. The purpose of this series was to report the contribution of 3-dimensional ultrasonographic (3DUS) technologies in performing the prenatal diagnosis of main stem bronchial atresia (BA). Methods. We report 2 cases in which the prenatal diagnosis of main stem BA was performed using 3DUS technologies. Both fetuses presented with extremely enlarged hyperechoic right lungs, shifting the mediastinum to the left, associated with hydrops and polyhydramnios. A revision of the literature was made, focusing on the prenatal characteristics and perinatal prognosis of main stem BA. Results. In the first case, a congenital type III cystic adenomatoid malformation was suspected initially, but a posterior 3DUS analysis on multiplanar imaging allowed identification of a dilated right bronchus, and a right main stem BA was confirmed at autopsy. In the second case, volume contrast imaging was used during fetal scanning, which also allowed identification of the right main bronchial dilatation. In reviewing the literature, we found a tendency for main stem BA to be more severe than lobar and segmental atresias. Conclusions. Three-dimensional ultrasonographic technologies may improve the prenatal diagnosis of main stem BA.