In-utero treatment of prenatal thoracic abnormalities by thoraco-amniotic shunts, short and long term neuro developmental outcome: A single center experience

Rosenblat, Orgad; Furman, Yael; Kimhi, Gal; Leibovitch, Leah; Mazkereth, Ram; Yinon, Yoav; Lipitz, Shlomo; Strauss, Tzipora; Weisz, Boaz

doi:10.1016/j.jpedsurg.2021.08.019

Cited by 6 publications

(2 citation statements)

References 32 publications

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“…This procedure is associated with a high rate of resolution of hydrops and perinatal survival (Figure 5). 12 Potential sequelae include shunt migration, preterm delivery and preterm rupture of membranes. The procedure can be technically challenging secondary to extensive skin oedema.…”

Section: Fetal Therapymentioning

confidence: 99%

Non‐immune hydrops fetalis: a practical guide for obstetricians

Khairudin

Alfirević

Mone

et al. 2023

The Obstetric & Gynaecologis

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Hydrops fetalis is the accumulation of two or more fetal fluid collections, including pericardial effusion, pleural effusion(s), ascites and skin oedema. In the absence of red cell alloimmunisation, hydrops fetalis is nonimmune and affects approximately 1 in 2000 pregnancies. Non-immune hydrops fetalis (NIHF) is associated with severe perinatal morbidity/mortality and significant maternal risks, including maternal mirror syndrome. Priorities for clinicians are determining the cause antenatally to optimise management and discuss treatment options, if available. Systematic reviews have indicated that a cause can be identified prenatally in ~60% cases. Recent evidence indicates fetal exome sequencing can provide a diagnosis in 30% of previously unexplained cases. Learning objectivesTo understand causes of NIHF and its association with perinatal and maternal morbidity and mortality To appreciate the basis for investigations for NIHF, including exome sequencing To understand how care can be effectively shared by referring units and tertiary fetal medicine units

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Section: Fetal Therapymentioning

confidence: 99%

Non‐immune hydrops fetalis: a practical guide for obstetricians

Khairudin

Alfirević

Mone

et al. 2023

The Obstetric & Gynaecologis

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“…In selected cases, treatment with pleuro-amniotic shunt (Shunt) has been shown to improve survival rate [4,5]. Recent case-series have also reported the longterm outcomes of pleuro-amniotic shunt [6][7][8][9]. The aim of this study was to investigate the perinatal and longterm outcomes of pleuro-amniotic shunt in a large cohort of FHT cases managed at a single center.…”

Section: Introductionmentioning

confidence: 99%

Fetal Hydrothorax Treated with Pleuro-Amniotic Shunting: Fetal and Maternal Complications and Long-Term Outcomes

et al. 2023

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Introduction We aimed to identify maternal and fetal complications and investigate post-natal and long-term outcomes of fetal hydrothorax (FHT) treated with pleuro-amniotic shunting (shunt). Methods Single-center retrospective observational cohort of shunt cases performed from 2000 to 2021. Risk factors for maternal complications, fetal demise, neonatal death (NND), and post-natal outcomes were identified. Results Out of 88 cases, 70 (79.5%) were complicated by hydrops, with an average gestational age (GA) at diagnosis of 27 weeks (range 16–34). In 16 cases, definitive etiology of FHT was identified; five cases of Noonan syndrome and three cases of monogenic disorders diagnosed by whole exome sequencing (EPHB4, VEGFR3, RASA1). Shunt was performed at an average GA of 28 weeks (20–34), with a dislodgement in 10 cases (11.4%). Maternal complications occurred in three cases; survival rate was 76.1% (67/88). Follow-up data were available for 57/67 (85.1%) children. Incidence of severe neurodevelopmental impairment and pneumopathy (broncho dysplasia, persistent pulmonary hypertension of newborn, and asthma) was 5.3% and 8.8%, respectively. Post-treatment persistence of hydrops, FHT associated with genetic syndromes, and GA at birth were risk factors for fetal demise, NND, and post-natal complications. Conclusion In truly isolated FHT, whenever indicated, pleuro-amniotic shunting is a safe procedure associated with good survival rate and long-term outcome.

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