Bronchopulmonary Sequestration (BPS)

Bronchopulmonary sequestration (BPS), or pulmonary sequestration, is a condition in which one section of lung does not communicate with the normal lung tissue. Because the BPS is not connected to the normal lung, the BPS does not function in respiration (breathing). The blood supply of a BPS does not arise from the pulmonary blood supply.

BPS can be detected in a fetus by prenatal ultrasound. The lesion appears as an echogenic (bright) lobar or triangular shaped mass. It is usually seen in the lower left chest. Rarely a BPS can become relatively large and act as a space-occupying lesion within the fetal chest. This can result in underdevelopment of the lung tissue and lethal pulmonary hypoplasia, as well as compression of cardiovascular structures and eventual fetal hydrops (heart failure) and death.

Fetal treatment is indicated in cases of BPS complicated with hydrops (heart failure). In these cases, the feeding vessels that feed the BPS can be targeted and occluded via laser energy or sclerotherapy. The hydrops fetalis usually resolves in three to four weeks.