Pulmonary Sequestration

Small or moderate-sized pulmonary sequestrations that don't change much during the pregnancy can be successfully managed after birth, usually with surgery to remove the abnormal lung tissue. These babies typically do not have any difficulty during pregnancy or after birth.

All pulmonary sequestrations should be surgically removed because the high blood flow through the tissue can cause heart failure. This surgery is quite safe even in the first year of life, and does not compromise lung function or development. These children will grow up normally and have normal lung function.

Fetuses who do not have hydrops when the lesion is first detected must be followed closely with ultrasounds at least every week to look for the development of hydrops. Fetal hydrops is the build-up of excess fluid, which can be seen in the fetal abdomen, lungs, skin or scalp.

If the baby doesn't develop hydrops, the medical team will continue to follow a "wait and see" approach with close follow-up. Many of these lesions begin to decrease in size before 26 weeks of pregnancy, and almost all can be safely dealt with after birth at a tertiary perinatal center. Some lesions even take care of themselves entirely.

A few fetuses develop fluid collection in the chest cavity, which may be treated by placing a catheter shunt to drain the chest fluid into the amniotic fluid.

If the fetus has a very large lesion that will make resuscitation after delivery dangerous, a specialized delivery can be planned, called the ex utero intrapartum treatment (EXIT) procedure. The UCSF Fetal Treatment Center developed the EXIT procedure to manage fetal airway emergencies, but it can be adapted to facilitate immediate support with an extracorporeal membrane oxygenation (ECMO) machine, similar to a heart-lung bypass machine, or for surgical removal of very large lesions while the baby remains attached to the placenta. This is rarely necessary for pulmonary sequestrations.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Intensive Care Nursery
1975 Fourth St., Third Floor
San Francisco, CA 94158
Phone: (415) 353-1565
Fax: (415) 353-1202

Fetal Treatment Center
1855 Fourth St., Second Floor, Room A-2432
San Francisco, CA 94158
Phone: (800) 793-3887
Fax: (415) 502-0660
Appointment information

Surgery Clinic
1825 Fourth St., Fifth Floor, 5B
San Francisco, CA 94158
Phone: (415) 476-2538
Fax: (415) 476-2929
Appointment information