Ex Utero intrapartum treatment of extralobar pulmonary sequestration: case report and literature review

Sofija Jackevičiūtė1, Jelena Volochovič1,2

1 Vilnius University, Faculty of Medicine, M. K. Čiurlionio street 21, Vilnius, Lithuania

2 Vilnius University hospital, Santaros clinic, Obstetrics, and Gynecology Center, Santariškių street 2, Vilnius, Lithuania


Background: Extralobar pulmonary sequestration is an uncommon congenital lung lesion, very rarely causing severe symptoms prenatally or requiring prompt surgical actions taken. The purpose of this report is to present a unique symptomatic case of extralobar pulmonary sequestration which led to an Ex Utero intrapartum treatment being performed for the first time in Lithuania and followed with successful further treatment of pulmonary pathology.

            Case presentation: A nulliparous caucasian patient at 22 years of age was sent to  a tertiary level clinic after alarming results were found during routine ultrasound examination at 29+4 weeks of gestation. After a detailed examination, extralobar pulmonary sequestration was diagnosed. Due to severely worsening fetal condition on week 32 of gestation the pregnancy was no longer continued and an Ex Utero intrapartum treatment procedure was performed. The pulmonary pathology later was surgically resected at 6 months of age.

            Conclusion: This rare case of extralobar pulmonary sequestration allows us to explore key moments in the diagnostic and treatment pathways of this pathology. Magnetic resonance imaging, which allows evaluating parous patients more precisely than ultrasound imaging, with fetal pulmonary vessels being seen more clearly, is inspected as a necessary step in fetal lung sequestration diagnosis establishment. The Ex Utero intrapartum treatment procedure and how anticipated respiratory challenges of the newborn can be tackled with its implementation leading to timely execution of crucial interventions is researched.

Keywords:  intrapartum, treatment, procedures.