S Christopher Derderian1, Shivika Trivedi1, Jody Farrell2, Roberta L Keller3, Larry Rand4, Ruth Goldstein5, Vickie A Feldstein5, Shinjiro Hirose1, Tippi C MacKenzie6. 1. Fetal Treatment Center, University of California, San Francisco, CA, USA; Department of Surgery, University of California, San Francisco, CA, USA. 2. Fetal Treatment Center, University of California, San Francisco, CA, USA. 3. Fetal Treatment Center, University of California, San Francisco, CA, USA; Department of Neonatology, University of California, San Francisco, CA, USA. 4. Fetal Treatment Center, University of California, San Francisco, CA, USA; Department of Obstetrics, University of California, San Francisco, CA, USA. 5. Fetal Treatment Center, University of California, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA. 6. Fetal Treatment Center, University of California, San Francisco, CA, USA; Department of Surgery, University of California, San Francisco, CA, USA. Electronic address: Tippi.Mackenzie@ucsfmedctr.org.
Abstract
OBJECTIVE: Primary hydrothorax is a rare congenital anomaly with outcomes ranging from spontaneous resolution to fetal demise. We reviewed our experience with fetuses diagnosed with primary hydrothorax to evaluate prenatal management strategies. METHODS: We reviewed the records of patients evaluated for fetal pleural effusions at our Fetal Treatment Center between 1996 and 2013. To define fetuses with primary hydrothorax, we excluded those with structural or genetic anomalies, diffuse lymphangiectasia, immune hydrops, and monochorionic diamniotic twin gestations. RESULTS: We identified 31 fetuses with primary hydrothorax, of whom 24 had hydrops. Hydropic fetuses were more likely to present with bilateral effusions. Of all fetuses with primary hydrothorax, 21 had fetal interventions. Survival without hydrops was 7/7 (100%), whereas survival with hydrops depended on whether or not the patient had fetal intervention: 12/19 (63%) with intervention and 1/5 (20%) without intervention. Premature delivery was common (44%) among those who had fetal intervention. CONCLUSIONS: Fetal intervention for primary hydrothorax may lead to resolution of hydrops, but preterm birth and neonatal demise still occur. Understanding the pathophysiology of hydrops may provide insights into further prenatal management strategies, including targeted therapies to prevent preterm labor.
OBJECTIVE: Primary hydrothorax is a rare congenital anomaly with outcomes ranging from spontaneous resolution to fetal demise. We reviewed our experience with fetuses diagnosed with primary hydrothorax to evaluate prenatal management strategies. METHODS: We reviewed the records of patients evaluated for fetal pleural effusions at our Fetal Treatment Center between 1996 and 2013. To define fetuses with primary hydrothorax, we excluded those with structural or genetic anomalies, diffuse lymphangiectasia, immune hydrops, and monochorionic diamniotic twin gestations. RESULTS: We identified 31 fetuses with primary hydrothorax, of whom 24 had hydrops. Hydropic fetuses were more likely to present with bilateral effusions. Of all fetuses with primary hydrothorax, 21 had fetal interventions. Survival without hydrops was 7/7 (100%), whereas survival with hydrops depended on whether or not the patient had fetal intervention: 12/19 (63%) with intervention and 1/5 (20%) without intervention. Premature delivery was common (44%) among those who had fetal intervention. CONCLUSIONS: Fetal intervention for primary hydrothorax may lead to resolution of hydrops, but preterm birth and neonatal demise still occur. Understanding the pathophysiology of hydrops may provide insights into further prenatal management strategies, including targeted therapies to prevent preterm labor.
Authors: Angie C Jelin; Nara Sobreira; Elizabeth Wohler; Benjamin Solomon; Teresa Sparks; Katelynn G Sagaser; Katherine R Forster; Jena Miller; P Dane Witmer; Ada Hamosh; David Valle; Karin Blakemore Journal: Prenat Diagn Date: 2020-02-17 Impact factor: 3.050
Authors: S Christopher Derderian; Cerine Jeanty; Shannon R Fleck; Lily S Cheng; Shabnam Peyvandi; Anita J Moon-Grady; Jody Farrell; Shinjiro Hirose; Juan Gonzalez; Roberta L Keller; Tippi C MacKenzie Journal: J Pediatr Surg Date: 2014-10-29 Impact factor: 2.545
Authors: Teresa N Sparks; Billie R Lianoglou; Rebecca R Adami; Ilina D Pluym; Kerry Holliman; Jennifer Duffy; Sarah L Downum; Sachi Patel; Amanda Faubel; Nina M Boe; Nancy T Field; Aisling Murphy; Louise C Laurent; Jennifer Jolley; Cherry Uy; Anne M Slavotinek; Patrick Devine; Ugur Hodoglugil; Jessica Van Ziffle; Stephan J Sanders; Tippi C MacKenzie; Mary E Norton Journal: N Engl J Med Date: 2020-10-07 Impact factor: 91.245
Authors: Abigail Wilpers; Anna Y Lynn; Barbara Eichhorn; Amy B Powne; Megan Lagueux; Janene Batten; Mert Ozan Bahtiyar; Cary P Gross Journal: Fetal Diagn Ther Date: 2022-03-10 Impact factor: 2.208