Perinatal outcome following fetal chest shunt insertion for pleural effusion
| Autor: | Yoav Yinon, Vandana Chaddha, Rory Windrim, P. G. R. Seaward, Edmond Kelly, O. Beresovska, S. Grisaru-Granovsky, Greg Ryan |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Pleural effusion Hydrops Fetalis Gestational Age Ultrasonography Prenatal Pleural disease Pulmonary hypoplasia Young Adult Catheters Indwelling Pregnancy Hydrops fetalis Medicine Humans Radiology Nuclear Medicine and imaging Amnion Survival rate Retrospective Studies Radiological and Ultrasound Technology business.industry Obstetrics Respiratory disease Pregnancy Outcome Obstetrics and Gynecology General Medicine medicine.disease Surgery Pleural Effusion Fetal Diseases Reproductive Medicine Pleurisy Hydrothorax Female business |
| Zdroj: | Ultrasound in obstetricsgynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 36(1) |
| ISSN: | 1469-0705 |
| Popis: | Objective To evaluate perinatal outcome of fetuses with primary pleural effusions following pleuroamniotic shunting. Methods This was a retrospective study of 88 fetuses with large pleural effusions referred to a tertiary fetal medicine unit between 1991 and 2008 which, after a thorough work-up, underwent pleuroamniotic shunting. Results At presentation, 59 (67.0%) fetuses were hydropic and 67 (76.1%) had bilateral effusions. In 17 (19.3%) fetuses, pleural fluid was aspirated prior to shunting and in 71 (80.7%), shunts were inserted directly as the first procedure. Mean gestational age at shunting was 27.6 (range, 18–37) weeks and at delivery 34.2 (range, 19–42) weeks. Seventy-four (84.1%) babies were born alive, of whom 52 (70.3%) survived the neonatal period. Of 59 hydropic fetuses, 10 (16.9%) died @ in utero and 18 neonates (30.5%) died, resulting in perinatal survival of 52.5%, whereas of 29 non-hydropic fetuses, perinatal survival was 72.4%. Hydrops resolved following shunting in 28 fetuses, of whom 71% survived, compared to 35% survival in 31 fetuses where hydrops persisted (P = 0.006). Of 22 neonatal deaths, seven were related to pulmonary hypoplasia, five to genetic syndromes, two to aneuploidy and one to a congenital anomaly (truncus arteriosus). Overall 13 (14.8%) were diagnosed with a chromosomal, genetic or other condition, several of which could not have been diagnosed antenatally. Conclusion Carefully selected fetuses with primary pleural effusions can benefit from pleuroamniotic shunting, allowing hydrops to resolve with a survival rate of almost 60%. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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