Children's Mercy is one of only a few centers in the region to offer fetal treatment for babies before they are born. Although most interventions for CPAM are performed after birth, fetal treatment may include:
Cyst aspiration, to puncture and drain a large CPAM cyst
Thoracoamniotic shunt placement - this procedure uses ultrasound guidance to place a straw-like tube into the baby's chest. This allows the CPAM cyst's fluid to drain out of the chest and into the amniotic fluid surrounding the baby
Removal of the cyst - this is only done prenatally in the rare case of a baby experiencing heart failure (hydrops) due to a very large CPAM
If it is not possible or necessary to provide treatment before birth, your care team will evaluate your baby as soon as possible after they are born and stable. Typically, doctors will schedule a surgery to remove the affected part of the lung. Removal helps eliminate the risk of infection and malignancy (cancer) in the future. Most babies have a very good prognosis once the CPAM is removed.
The timing of surgery depends on whether your baby's overall health is impacted by the CPAM. If the growth is relatively small and there are no problems with breathing or other concerns, you may be able to go home with your baby and schedule surgery for when they are 3-6 months old.
If the CPAM is causing problems for your baby, your doctors may recommend surgery shortly after birth in order to give your baby the best possible outcome. If this is the case, you may consider delivering your baby in the Special Care Delivery unit at the Fetal Health Center to ensure your baby receives immediate medical attention while still staying close by to you.
The surgical procedure consists of making either one incision (open technique) or a few smaller incisions (minimally invasive technique) in the side of the chest. This allows your surgeon to remove the affected lobe. Babies are able to do very well with the remainder of their healthy lung tissue after the CPAM is removed.
During the procedure, your baby will need general anesthesia and will have a tube in their chest after surgery for a few days. A follow-up chest X-ray helps doctors check for full expansion of the remaining lung tissue.
Most of the time, you can go home within a week after surgery. However, the length of stay in the NICU for an infant with this condition varies. Your baby will be able to go home when they are gaining weight and can tolerate full feedings. After discharge, a pediatrician will monitor your baby. Your baby will also come back to Children’s Mercy to see the pediatric surgeon or any other necessary specialists.
Outcomes and prognosis for CPAM
The outcomes for babies with CPAM are generally very good. In most cases, infants recover well and usually have no immediate issues after discharge from the hospital. It's important to follow up with your pediatrician or primary care provider for routine care during infancy and childhood.
Choosing the best home for your child's care
At Children’s Mercy, our skilled professionals can care for you and your baby before, during and after delivery. Our Fetal Health Center works with families like yours every day to help correct and prevent problems that happen during prenatal development.
Our team of pediatric surgeons was one of the first to apply minimally invasive surgical techniques (surgery through very small incisions) to infants and children. Our expertise in minimally invasive thoracic surgery means we are able to remove most CPAMs using these specialized techniques to minimize pain, scars, and days in the hospital for your child.