*Mordechai Pollak and Michal Gur contributed equally to this work
Background: The increased and earlier use of prenatal ultrasound has facilitated the detection of congenital thoracic malformations (CTMs). Our Pediatric Pulmonology Institute follows an increasing number of patients with CTMs. We sought to examine if the increased number of CTM reflects true higher incidence or the result of an increase early use of prenatal ultrasound.
Objectives: To evaluate prenatal sonography detection rates of CTM, and to estimate detection rates of these abnormalities over a period of 16 years.
Methods: A retrospective, cross section analysis of prenatal ultrasound screening tests carried out in large community based clinic affiliated to our hospital, comparing two periods – 2001-2007 and 2007-2017.
Results: In 2001-2007, 12,016 prenatal ultrasound tests detected 19 CTMs, compared to 30 CTMs out of 22,700 test in 2007-2017. Twenty CTMs, mainly congenital diaphragmatic hernia (CDH) and congenital pleural effusion (CPE) were associated with other fetal lesions. Detection rates did not change (1.58/1000 in 2001-2007 vs. 1.32/1000 in 2007-2017, p=0.64). The median (range) gestational age at diagnosis was 15.4 (11.6-23.9) and 15.7 (12-33.6) weeks in 2001-2007 and 2007-2017, respectively.
Conclusions: CTMs were diagnosed earlier than previously reported. CDH and CPE tend to appear with multiple lesions and warrant further attention. The incidence rates stayed stable when comparing the last decade to previous years. Thus, the increased referral of CTM can be attributed to an increased prenatal screening studies performed, rather than a change in detection rates.
