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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Congenital Cystic Adenomatoid Malformation During Pregnancy?

Hi Doc, Iam 33 yrs of age, diabetic(though its under control),and I have had 3 miscarriages in my 31/2 years marriage (including the last months delivery). Last month had a pre term delivery of a 5 month baby, as my baby was diagnosed with a weird complication CCAM(congenital cystic adenomatoid malformation, never heard about such problems). The doctors have neither a reason for why it happened nor they had a treatment to cure my lil one. Hence, the result was to terminate the pregnancy. Now I do not have anything more to lose as I have lost the most precious thing of my life, still trying to recover, the trauma still exists in my life and don t know till when it will be there with me. Have gone through lots of your questions and answers asked in your section here so just felt like sharing my condition with you. I know there is no use of asking now but just for my knowledge plz answer my questions.I just wanna know that is this complication incurable, firstly? Secondly, Was termination the only option in this case? Thirdly, What could have been the reason for such anomaly? Fourthly, When can I think about conceiving again? Fifthly, Can such complications have a history of recurrence as nobody in my or my husbands family have had any such problems? And last but not least will I ever be able to become a Mother as other women have the privilege to become. I want a child and I m desperate for it now. I have had my share of social pressures and intolerable amount of talks against me and m fed up of all this. I wanna give an answer to everyone once n for all that, Yes, I can also become a mother, I can also deliver a normal child inspite of all these problems in the past. Will I ever be able to do this doc. Plz help...I m disturbed, depressed and disgusted right now. Plz take me out of this... Thanks...abc
Wed, 12 Aug 2015
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OBGYN 's  Response
Hello, and I hope I can answer your questions. I performed a review of the medical literature to aid in my recommendation for you.

CCAM is a rare type of tumor that can occur in the lungs of a fetus before it is born. It is NOT inherited (so it does not run in families) and is a very rare condition in general and it has an unknown cause. The abnormal lung tissue can compress the lungs of the fetus resulting in the good lung tissue being compressed. If the baby does not have enough lung tissue at birth, it would not be able to breathe and would die at birth. So unless your baby was born in an extremely specialized children's hospital where they can perform emergency surgery at birth (there are only a handful of hospitals in the US that even do this) the condition would cause death of the baby and it was the right decision to terminate the pregnancy.

So in summary about CCAM, it is a rare disorder that has an unknown cause and has very poor prognosis. Therefore, what happened to you is just a really awful, unpredictable tragedy, and has NO evidence that it will ever happen to you with any future pregnancy in your life. It is NOT your or your husband's fault about anything that happened.

It is completely normal to feel depressed, frustrated and blame yourself from pregnancy loss, and it is normal to grieve for the child you lost. Counseling, if it is available to you, can help in those situations, as well possibly as medication to treat depression. You should discuss this all with your family physician.

I do want to clarify # 4 and #5 part of your question as well. Even if you had a history of 3 miscarriages, you did conceive four times... And if your baby had not had this incredibly rare, unpredictable birth defect, you could have carried to term. Therefore there is NO REASON that you should not be able to conceive again and carry a pregnancy to term. I suggest you consult with a high-risk obstetrician early in your next pregnancy anyway, as they will probably perform early tests and ultrasounds to make sure everything is OK as early as possible. You can begin to try to get pregnant again as soon as your period comes back, but I suggest you take some time to grieve and mentally prepare for the stress of trying this again. I do not know how old you are, but if you are under 35 there is plenty of time to wait to get pregnant again as well.

So I want to reassure you that you are normal and I hope you do achieve a successful pregnancy. Once you do start to try to conceive again, please begin taking prenatal vitamins as they help prevent other kinds of birth defects. I hope this makes you feel better and that my advice was helpful to you.

Best regards, Dr. Brown
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What Causes Congenital Cystic Adenomatoid Malformation During Pregnancy?

Hello, and I hope I can answer your questions. I performed a review of the medical literature to aid in my recommendation for you. CCAM is a rare type of tumor that can occur in the lungs of a fetus before it is born. It is NOT inherited (so it does not run in families) and is a very rare condition in general and it has an unknown cause. The abnormal lung tissue can compress the lungs of the fetus resulting in the good lung tissue being compressed. If the baby does not have enough lung tissue at birth, it would not be able to breathe and would die at birth. So unless your baby was born in an extremely specialized children s hospital where they can perform emergency surgery at birth (there are only a handful of hospitals in the US that even do this) the condition would cause death of the baby and it was the right decision to terminate the pregnancy. So in summary about CCAM, it is a rare disorder that has an unknown cause and has very poor prognosis. Therefore, what happened to you is just a really awful, unpredictable tragedy, and has NO evidence that it will ever happen to you with any future pregnancy in your life. It is NOT your or your husband s fault about anything that happened. It is completely normal to feel depressed, frustrated and blame yourself from pregnancy loss, and it is normal to grieve for the child you lost. Counseling, if it is available to you, can help in those situations, as well possibly as medication to treat depression. You should discuss this all with your family physician. I do want to clarify # 4 and #5 part of your question as well. Even if you had a history of 3 miscarriages, you did conceive four times... And if your baby had not had this incredibly rare, unpredictable birth defect, you could have carried to term. Therefore there is NO REASON that you should not be able to conceive again and carry a pregnancy to term. I suggest you consult with a high-risk obstetrician early in your next pregnancy anyway, as they will probably perform early tests and ultrasounds to make sure everything is OK as early as possible. You can begin to try to get pregnant again as soon as your period comes back, but I suggest you take some time to grieve and mentally prepare for the stress of trying this again. I do not know how old you are, but if you are under 35 there is plenty of time to wait to get pregnant again as well. So I want to reassure you that you are normal and I hope you do achieve a successful pregnancy. Once you do start to try to conceive again, please begin taking prenatal vitamins as they help prevent other kinds of birth defects. I hope this makes you feel better and that my advice was helpful to you. Best regards, Dr. Brown