Outcome of neonatal chylous effusions: what do you tell the parents? A 10-year experience in a community hospital.

OBJECTIVE

The aim of the study was to describe our cases of neonatal chylous effusions and their outcomes and attempt to identify prognostic factors that can aid in the counseling of parents of future patients.

PATIENTS AND

METHODS

A retrospective chart review was conducted on all patients with a diagnosis of chylous effusions admitted to our 16-bed community level-3 neonatal intensive care unit (NICU) between June 2003 and November 2013.

RESULTS

A total of 10 patients were identified: of these 10 patients, 3 survived and 6 expired. One patient was transferred out and was lost to follow-up. Two-thirds of the survivors had only one site of chylous effusion. The six mortalities were all of gestational age (GA) < 34 weeks; five of the six were low birth weight (LBW) and all six had anasarca/hydrops, two or more sites of chylous effusions, or a genetic syndrome/chromosomal abnormality. The incidence of chylous effusions was 0.03% of all births and these patients constituted 0.37% of the inborn admissions to the NICU.

CONCLUSIONS

This case series represents a large number of patients considering its single-center community setting. It is prudent to communicate a very guarded prognosis when counseling parents of neonates with chylous effusions. Multiple chylous effusions, hydrops, GA < 34 weeks, LBW, or an accompanying genetic syndrome appear to confer worse prognosis.