Diana Wellesley1, David T Howe2. 1. Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK. 2. Wessex Fetal Medicine Unit, Princess Anne Hospital, Southampton, UK.
Abstract
OBJECTIVE: To determine the outcome of all pregnancies with nonhydropic fetal pleural effusions in the Wessex region. METHOD: Data were extracted from the Wessex congenital anomaly database for the years 1994-2015 inclusive. RESULTS: Sixty-two fetuses and babies were identified giving a total prevalence of 1:9500. Eight fetuses had bilateral effusions with additional, nonhydrops anomalies, and 54 had isolated effusions. Of the isolated cases, 36 presented before 24-week gestation: 12 were unilateral and 24 bilateral. All of the unilateral effusions resolved before or soon after birth with no other diagnosis but of the bilateral cases, four (17%) had a trisomy and three (13%) a genetic or syndrome diagnosis. Eighteen isolated cases presented after 24-week gestation, six were unilateral of which one had trisomy 21 (17%), and three (50%) Noonan's or another lymphoedema syndrome. Twelve were bilateral: One had trisomy 21, one an unbalanced translocation (17%), three had Noonan's or another lymphoedema syndrome, and two an unspecified syndrome (42%) at birth. CONCLUSION: These data suggest that a chromosomal microarray should be offered to all fetuses presenting with a pleural effusion in the absence of hydrops, and Noonan's syndrome testing should be considered for those that develop after 24 weeks. AIM: To determine the outcome of all pregnancies with nonhydropic fetal pleural effusions in the Wessex region from 1994-2015.
OBJECTIVE: To determine the outcome of all pregnancies with nonhydropic fetal pleural effusions in the Wessex region. METHOD: Data were extracted from the Wessex congenital anomaly database for the years 1994-2015 inclusive. RESULTS: Sixty-two fetuses and babies were identified giving a total prevalence of 1:9500. Eight fetuses had bilateral effusions with additional, nonhydrops anomalies, and 54 had isolated effusions. Of the isolated cases, 36 presented before 24-week gestation: 12 were unilateral and 24 bilateral. All of the unilateral effusions resolved before or soon after birth with no other diagnosis but of the bilateral cases, four (17%) had a trisomy and three (13%) a genetic or syndrome diagnosis. Eighteen isolated cases presented after 24-week gestation, six were unilateral of which one had trisomy 21 (17%), and three (50%) Noonan's or another lymphoedema syndrome. Twelve were bilateral: One had trisomy 21, one an unbalanced translocation (17%), three had Noonan's or another lymphoedema syndrome, and two an unspecified syndrome (42%) at birth. CONCLUSION: These data suggest that a chromosomal microarray should be offered to all fetuses presenting with a pleural effusion in the absence of hydrops, and Noonan's syndrome testing should be considered for those that develop after 24 weeks. AIM: To determine the outcome of all pregnancies with nonhydropic fetal pleural effusions in the Wessex region from 1994-2015.
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