Antepartum diagnosis and management of idiopathic pericardial and pleural effusion: report of one case.

A case of an antenatal ultrasound diagnosis of pericardial effusion with pleural effusion is reported. Fetal pericardiocentesis, thoracentesis and amniocentesis were performed with real-time ultrasound guidance at 37 weeks of gestation. Laboratory investigations reported a rhesus-positive blood group, no atypical antibodies, negative serologic test for syphilis, and negative titers for toxoplasmosis. The laboratory data of the pericardial effusion showed: glucose 71 mg/dl, protein 3.7 gm/dl, LDH 73 U/L, CPK 53 U/L, negative culture for virus and bacteria. The pregnancy was terminated at 37 weeks of gestation by Cesarean section because of an edematously enlarged thorax. A 3540 gm male infant was delivered in a state of asphyxia with general cyanosis and an Apgar score of 3 and 4 at one and five minutes, respectively. His condition improved after endotracheal intubation and assisted ventilation. He was transported to the neonate intensive care unit, where chest roentgenogram confirmed pleural effusion over the left side. Chest tube was placed for 7 days. The infant was discharged on day 8, but the fluid reaccumulation over the left lung four months later. Chest tube was placed for five days. The infant subsequently has thrived with appropriated development for his age. We report herein because of successful technique of antepartal intervention.