General Obstetrics and Gynecology: ObstetricsThoracoamniotic shunting for fetal pleural effusions with hydrops
Section snippets
Material and methods
Between 1984 and 2002, 54 patients underwent thoracoamniotic shunting for pleural effusions with fetal hydrops. The detailed perinatal outcome and postnatal treatment of the 21 first cases are reported in the previous publication.6 The mean maternal age was 33 years (range, 22-38 years), and the mean parity was 2 (range, 1-5). No patient had a significant family history, and none of the parents were consanguineous.
Among patients who were referred to our fetal medicine unit for fetal pleural
Results
Thoracoamniotic shunting was performed at a mean gestational age of 30 weeks (range, 19-36 weeks). Shunting was bilateral in 37 cases and unilateral in 17 cases (right, 7 cases; left, 10 cases).
Polyhydramnios, which was defined by an amount of amniotic fluid, such that it induced uterine contractions and maternal discomfort, occurred in 22 cases; amniodrainage was required in 14 cases. One to 3.8 liters of amniotic fluid were drained during the shunting procedure.
Shunt placement was performed
Comment
Our results confirm that a survival rate of >50% can be achieved by thoracoamniotic shunting in fetal pleural effusions that are complicated by hydrops. The main morbidity that is associated with the procedure is a substantial risk of PPROM and premature delivery.
Pleural effusion is among the most common indications for in utero shunting since the first reports of pleuroamniotic shunting for fetal hydrothorax by Booth et al,3 Blott et al,4 Rodeck et al.5 The rationale for thoracoamniotic
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