Our long experience with prenatal diagnosis and planning for optimum care allows us to offer the highest quality treatment whether intervention is indicated before or after birth.
Under the direction of Dr. Michael Harrison, the Fetal Treatment Center was the first institution to develop fetal surgery techniques. The first open fetal surgery in the world was performed at UCSF since the early 1980's. We presently have more experience with fetal surgery and endoscopic fetal intervention (FETENDO fetal surgery) than any other institution in the world. We are dedicated to pulmonary sequestration research and treatment innovation.
A pulmonary sequestration (also known as bronchopulmonary sequestration) is a cystic piece of abnormal lung tissue that does not work like normal lung tissue. They usually appear next to the lung (extrapulmonary, aka extralobar sequestration) or within one part of the lung (intrapulmonary, aka intralobar sequestration). We do not know what causes one part of the lung to develop abnormally. The cystic tissue involved will never function as normal lung tissue.
The majority of these fetuses have a very good outcome. Pulmonary sequestrations remain the same size or grow with the fetus, but usually do not cause severe problems, probably because there remains enough room for the normal part of the lung to grow. The mass may shrink in size before birth. In all these cases, the outlook for a normal life is excellent. These fetuses should be followed closely, delivered near term, and the pulmonary sequestration removed surgically after birth — often the removal is an elective proceedure in early childhood.
In order to determine the severity of your fetus's condition it is important to gather information from a variety of tests and determine if there are any additional problems. These tests along with expert guidance are important for you to make the best decision about the proper treatment.
Most fetuses with pulmonary sequestrations do not require intervention during the pregnancy and will do well with management after birth (usually surgery to remove the abnormal piece of lung). Fetuses with pulmonary sequestrations, identified by an abnormal artery on ultrasound, usually do well with surgical removal after birth.
A few fetuses develop fluid collections in the chest cavity which may be treated by placing a Harrison catheter shunt (aka thoraco-amniotic shunt). In this proceedure a special catheter shunt is placed in the fetal chest to drain fluid out and into the amniotic sac.
Fetuses with small or moderate-sized pulmonary sequestrations that do not change much during pregnancy can be successfully managed after a normal birth. They usually do not have any difficulty during pregnancy or after birth. Unlike CCAMs, all pulmonary sequestrations should be surgically removed because of the high blood flow through the lesion that can cause heart failure. This surgery is quite safe even in the first year of life and does not compromise lung function or the normal development of the baby. These children will grow up normally and have normal lung function.
Baby Sarah Elizabeth has a very successful recovery from an SCT which is removed while she is still a fetus.