Prenatal diagnosis and natural history of fetuses presenting with pleural effusion

Ruano, Rodrigo; Ramalho, Alan Saito; Cardoso, Ana Karina Silva; Moise, Kenneth J.; Zugaib, Marcelo

doi:10.1002/pd.2726

Cited by 36 publications

(35 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Even though survival rates for prenatal intervention (50%) and conservative management (52%) were similar in our cohort, those surviving after fetal therapy would likely not have survived if management had been conservative [15,16,21]. The 13 survivors from our conservative group predominantly had only mild or moderate-sized, unilateral effusions at presentation, which did not demonstrate clinical progression at follow-up.…”

Section: Discussionmentioning

confidence: 95%

The Outcome of Isolated Primary Fetal Hydrothorax: A 10-Year Review from a Tertiary Center

et al. 2013

View full text Add to dashboard Cite

Introduction: The management of primary fetal pleural effusion remains a challenge for clinicians given the paucity of clinical information to guide practice. Materials and Methods: A retrospective descriptive study of cases referred for management to our fetal therapy center over a 10-year period. Survival to hospital discharge was evaluated against case characteristics and prenatal intervention. For this study, we categorized the severity of the pleural effusion at diagnosis as mild, moderate or severe, and the clinical course as regression, stable or progression. Results: Forty-five of the 103 pregnancies complicated by fetal pleural effusions during the study period were managed for primary effusions. Termination of pregnancy was requested in 6 cases. Thirty-nine pregnancies continued management, with 14 undergoing prenatal intervention. The overall survival rate to hospital discharge was 51%, including 7 survivors after prenatal intervention. The rate of survival was low if the effusion was categorized as severe at diagnosis or if there was progression of the clinical course. Conclusions: Case characteristics at the time of diagnosis and clinical course can be used to guide patient counseling and decision-making regarding fetal therapy. Prenatal intervention may improve the chance of survival in cases with characteristics associated with a poor prognosis.

show abstract

Section: Discussionmentioning

confidence: 95%

The Outcome of Isolated Primary Fetal Hydrothorax: A 10-Year Review from a Tertiary Center

et al. 2013

View full text Add to dashboard Cite

show abstract

“…This underlines the importance of a thorough ultrasound evaluation of the fetus as these malformations can influence both intrauterine survival as well as long-term outcome and have been associated with higher mortality [2] . The number of fetal aneuploidies of 18% in our study is also consistent with previous studies reporting 4.5-41.1% aneuploidies [2-5, 9, 19] and promotes fetal karyotyping in prenatally diagnosed hydrothorax [4,20] .…”

Section: Discussionmentioning

confidence: 99%

Thoracoamniotic Shunting for Fetal Hydrothorax: Predictors of Intrauterine Course and Postnatal Outcome

Mallmann¹,

Graham²,

Rösing³

et al. 2016

Fetal Diagn Ther

View full text Add to dashboard Cite

Objective: To assess predictors for survival and complications among a relatively large cohort of fetuses with hydrothorax treated by thoracoamniotic shunting. Methods: All cases with hydrothorax treated by thoracoamniotic shunting in a 10-year period (2002-2011) in two centers were retrospectively reviewed. Results: A total of 78 fetuses with hydrothorax treated with thoracoamniotic shunting were included in the study. Mean gestational age at diagnosis was 25.6 weeks (12-34 weeks). Initial thoracoamniotic shunting was performed at a mean gestational age of 26.5 weeks (16-33 weeks). A mean of 2.53 shunts (1-7) were inserted per fetus. Of the 78 fetuses, 9 (11.5%) died in utero, 69 (88.5%) were born alive and 46 (59%) survived. Prognostic markers significantly associated with nonsurvival were polyhydramnios, hydrops placentae and mediastinal shift at initial scan, onset of hydrops after first shunt placement, rupture of membranes, a shunt-birth interval <4 weeks and low gestational age at birth. In our cohort, fetuses with trisomy 21 had a significantly better survival than euploid fetuses. Conclusions: Although associated with a significant rate of repeated interventions, thoracoamniotic shunting in fetuses with severe hydrothorax results in an overall survival rate of 59%. Fetuses with hydrothorax and trisomy 21 have a better survival when compared to euploid fetuses.

show abstract

“…54 Bilateral hydrothorax is more often associated with fetal hydrops (71.4%), compared to unilateral hydrothorax (14.3%). 54 If we exclude the associated pathologies described by Ruano et al, the negative prognostic factors are: low gesta tional age at which the diagnosis was performed and at which the baby was delivered, the occurrence of hydrops and a bilateral form of hydrothorax. 51 A review of the literature showed that after multivariate analysis, hydrops remained the only negative prognostic factor.…”

Section: Bilateral Lung Hypoplasia With Hydrothoraxmentioning

confidence: 95%

“…5153 In 72.3 to 81% of cases, the hydrothorax is bilateral and, in 84% of cases, it is diagnosed in the third trimester of pregnancy. 51,54 Compared to the unilateral hydro thorax, the bilateral one is more often associated with malformations (21% vs 78.9%) or chromosomal abnor malities (17.4% vs 82.6%). 54 Bilateral hydrothorax is more often associated with fetal hydrops (71.4%), compared to unilateral hydrothorax (14.3%).…”

Section: Bilateral Lung Hypoplasia With Hydrothoraxmentioning

confidence: 98%

“…51,54 Compared to the unilateral hydro thorax, the bilateral one is more often associated with malformations (21% vs 78.9%) or chromosomal abnor malities (17.4% vs 82.6%). 54 Bilateral hydrothorax is more often associated with fetal hydrops (71.4%), compared to unilateral hydrothorax (14.3%). 54 If we exclude the associated pathologies described by Ruano et al, the negative prognostic factors are: low gesta tional age at which the diagnosis was performed and at which the baby was delivered, the occurrence of hydrops and a bilateral form of hydrothorax.…”

Section: Bilateral Lung Hypoplasia With Hydrothoraxmentioning

confidence: 98%

See 1 more Smart Citation

Lung Malformations: Prenatal Ultrasound Diagnosis and Obstetrical Management

Iliev¹,

Dumitrascu²,

Grigore³

et al. 2014

Donald School Journal of Ultrasound in Obstetrics and Gynecology

View full text Add to dashboard Cite

Purpose:We present our experience in prenatal diagnosis and obstetrical management of congenital lung malformations (CLM). Materials and methods:The diagnosis of CLM was performed during routine second and third trimester fetal morphology assess ment. The extent of the disease was established accor ding to the type, localization and size of the pulmonary lesion and the presence of fetal complications (mediastinal shift, fetal hydrops, hydramnios). Termination of pregnancy (TOP) was indicated in cases associated with extrapulmonary anomalies, untreatable cases and fetal hydrops. After delivery a pulmonary Xray and surgical examination was performed in all newborns. Results:We diagnosed 15 cases with congenital lung mal for ma tions. Of these, 9 had congenital cystic adenomatoid malfor mation (CCAM). TOP was performed in 6 cases with CCAM. Three cases had a favorable pre/postnatal evolution. Bronchopulmo nary sequestration (BPS) was diagnosed in 3 cases, all with favorable perinatal evolution. Right pulmonary agenesis was diagnosed in one case and the outcome was neonatal death. One case of congenital high airway obstruction syn drome was followed by TOP. One case of severe bilateral pul monary hy poplasia (secondary to a severe bilateral hydrothorax) resulted in neonatal death. Conclusion:Obstetrical management is established individually depending on the severity of the cases.

show abstract

Prenatal diagnosis and natural history of fetuses presenting with pleural effusion

Cited by 36 publications

References 10 publications

The Outcome of Isolated Primary Fetal Hydrothorax: A 10-Year Review from a Tertiary Center

The Outcome of Isolated Primary Fetal Hydrothorax: A 10-Year Review from a Tertiary Center

Thoracoamniotic Shunting for Fetal Hydrothorax: Predictors of Intrauterine Course and Postnatal Outcome

Lung Malformations: Prenatal Ultrasound Diagnosis and Obstetrical Management

Contact Info

Product

Resources

About