Nobuhiro Hidaka1, Yoshihide Chiba. 1. Department of Perinatology, National Cardiovascular Center, Osaka, Japan. n-hidaka@kpa.biglobe.ne.jp
Abstract
BACKGROUND: Although fetal hydrothorax is uncommon, perinatal mortality from it is high. The clinical course of fetal hydrothorax is highly variable. Despite some cases of spontaneous resolution, fetal hydrothorax progresses to nonimmune hydrops because of impaired venous return and congestive cardiac failure due to compression in many cases. Although the effect of thoracoamniotic shunting is established, the procedure is invasive and involves some risks. CASES: Two cases of fetal hydrothorax completely resolved after a single thoracentesis. In the first case, thoracentesis was performed in a fetus with bilateral isolated pleural effusion at the gestational age of 20 weeks. Fetal hydrothorax achieved complete resolution after a single thoracentesis was performed, and the perinatal outcome was good. In the second case, we performed thoracentesis in a fetus with a unilateral pleural effusion and skin edema at the gestational age of 17 weeks. Complete resolution was achieved after a single thoracentesis, and the outcome was uneventful. CONCLUSION: Thoracentesis is a comparatively simple procedure for mothers and fetuses and should be the first choice for treating fetal hydrothorax.
BACKGROUND: Although fetal hydrothorax is uncommon, perinatal mortality from it is high. The clinical course of fetal hydrothorax is highly variable. Despite some cases of spontaneous resolution, fetal hydrothorax progresses to nonimmune hydrops because of impaired venous return and congestive cardiac failure due to compression in many cases. Although the effect of thoracoamniotic shunting is established, the procedure is invasive and involves some risks. CASES: Two cases of fetal hydrothorax completely resolved after a single thoracentesis. In the first case, thoracentesis was performed in a fetus with bilateral isolated pleural effusion at the gestational age of 20 weeks. Fetal hydrothorax achieved complete resolution after a single thoracentesis was performed, and the perinatal outcome was good. In the second case, we performed thoracentesis in a fetus with a unilateral pleural effusion and skin edema at the gestational age of 17 weeks. Complete resolution was achieved after a single thoracentesis, and the outcome was uneventful. CONCLUSION: Thoracentesis is a comparatively simple procedure for mothers and fetuses and should be the first choice for treating fetal hydrothorax.