American journal of obstetrics and gynecology · 2004
Thoracoamniotic shunting for fetal pleural effusions with hydrops.
СтатьяНазвание и аннотация: Перевод в очереди
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Picone Olivier, Benachi Alexandra, Mandelbrot Laurent, Ruano Rodrigo, Dumez Yves, Dommergues Marc
Аннотация
OBJECTIVE: The purpose of this study was to evaluate perinatal outcome after thoracoamniotic shunting for fetal pleural effusions with hydrops.
STUDY DESIGN: This was a retrospective study.
RESULTS: Shunting was performed immediately after diagnosis and was successful in all 54 of the cases that were attempted. There were 7 pregnancy terminations, 9 in utero deaths, and 38 live births, of which 7 children died in the neonatal period and 31 children survived. Among the liveborn infants, 27 infants were delivered preterm (71%), of whom 7 infants (15%) had preterm premature rupture of membranes and 4 infants (8.5%) had chorioamnionitis. Perinatal death (23/54 infants; 43%) was related to underlying anomalies (7 cases), pulmonary hypoplasia (5 cases), chorioamnionitis (2 cases), or treatment failure for unknown reasons (9 cases). All 31 survivors had chylothorax; for 28 of the survivors, the chylothorax was primary, and for 3 survivors, the chylothorax was the result of right congenital diaphragmatic hernia, pulmonary sequestration, or Noonan syndrome.
CONCLUSION: After the shunting, pleural effusion with hydrops has a 57% survival rate; premature delivery is the leading source of morbidity.
STUDY DESIGN: This was a retrospective study.
RESULTS: Shunting was performed immediately after diagnosis and was successful in all 54 of the cases that were attempted. There were 7 pregnancy terminations, 9 in utero deaths, and 38 live births, of which 7 children died in the neonatal period and 31 children survived. Among the liveborn infants, 27 infants were delivered preterm (71%), of whom 7 infants (15%) had preterm premature rupture of membranes and 4 infants (8.5%) had chorioamnionitis. Perinatal death (23/54 infants; 43%) was related to underlying anomalies (7 cases), pulmonary hypoplasia (5 cases), chorioamnionitis (2 cases), or treatment failure for unknown reasons (9 cases). All 31 survivors had chylothorax; for 28 of the survivors, the chylothorax was primary, and for 3 survivors, the chylothorax was the result of right congenital diaphragmatic hernia, pulmonary sequestration, or Noonan syndrome.
CONCLUSION: After the shunting, pleural effusion with hydrops has a 57% survival rate; premature delivery is the leading source of morbidity.
Предметные рубрики MeSH
Amniotic FluidCohort StudiesDrainageFemaleFetal DeathGestational AgeHumansHydrops FetalisHydrothoraxInfant, NewbornInfant, PrematureObstetric Labor, PrematurePleural EffusionPregnancyPregnancy OutcomePrognosisRetrospective StudiesRisk AssessmentSeverity of Illness IndexSurvival RateThoracostomyUltrasonography, Prenatal