Successful in utero Percutaneous Fetoscopic Release of a Wrapped Pleuro-Amniotic Shunt around the Fetal Arm: Case Report and Review of the Literature

Nassr, Ahmed A.; Ruano, Rodrigo; Espinoza, Jimmy

doi:10.1159/000450606

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…After prenatal and postnatal evaluations, we concluded that the most common underlying reasons for NIHF were idiopathic and cardiogenic ( n = 7; 15.2%) and urinary disorders ( n = 4; 8.9%). These findings are consistent with the results of recent studies conducted by Nassr, Ruano, Espinoza, and Shamshirsaz (), who reported the most common idiopathic and cardiac reasons in the etiology of NIHF. Bellini et al () conducted a comprehensive review of the literature and included 75 related publications and 6,775 NIHF subjects (Bellini et al, ; Bellini et al, ).…”

Section: Discussionsupporting

confidence: 93%

“…In the study conducted by Yeom et al (), the number of infants who lived 28 days after 35 livebirths was 16 (45.7%). In a multicenter study conducted by Nassr, Ruano, et al (), 57 (50%) of the 114 patients were discharged. Although the survival rates of our patients who had IHF were higher ( n = 12/15; 80%), this rate was lower in patients with NIHF ( n = 10/31; 32.3%) compared with the literature.…”

Section: Discussionmentioning

confidence: 97%

“…In one study, there was no significant difference in perinatal mortality between fetuses with idiopathic NIHF with or without fetal intervention (Nassr et al, ). It has been reported in the literature that fetal intervention can pose a risk without any benefit and increase neonatal mortality even further (Mann, Johnson, & Wilson, ; Nassr, Ness, et al, ; Nassr, Ruano, et al, ). Unlike the literature, the survival rate was high in our study; 81.2% of the patients who underwent in utero therapy among the prenatal interventions accepted to NICU survived (16 patients received fetal intervention, 13 were discharged, and 12 of them received in utero blood transfusion).…”

Section: Discussionmentioning

confidence: 99%

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Clinical characteristics and neonatal outcomes of liveborn newborns with hydrops fetalis treated in a tertiary level neonatal intensive care unit

Emiroğlu

Yılmaz

Keçeci

et al. 2020

Birth Defects Research

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Background: This study was performed for examining the neonatal results and aetiological factors of neonates with hydrops fetalis (HF) and determining the factors affecting mortality. Methods:The medical records of liveborn neonates with HF who were admitted to a tertiary Neonatal Intensive Care Unit (NICU) in Konya, Turkey, between 2013 and 2019 were reviewed retrospectively. The demographic data, prenatal intervention, clinical findings, and results of the patients were recorded.Results: A total of 32.6% of the 46 liveborn HF infants had immune HF (IHF), while 67.4% had nonimmune HF (NIHF); there was prenatal diagnoses in 39 (84.7%) cases. Cordocentesis and blood transfusion (n = 14; 30.4%) were the prenatal diagnosis and treatment interventions with the highest rate. A total of 16 patients (34.7%) received in utero interventional treatment. It was determined that the mean gestational age was not associated with mortality; moreover, birthweight (BW), Apgar score and the need for mechanical ventilation affected mortality. Conclusion: The prognosis changes according to different etiologies of HF. However, despite the developments in neonatal care, mortality is still high in HF infants. K E Y W O R D S etiology, hydrops fetalis, neonatal outcome, newborn, survival

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Clinical characteristics and neonatal outcomes of liveborn newborns with hydrops fetalis treated in a tertiary level neonatal intensive care unit

Emiroğlu

Yılmaz

Keçeci

et al. 2020

Birth Defects Research

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“…We did not show any significant difference in perinatal mortality rate between fetuses with idiopathic NIHF (non-pressure hydrothorax) who underwent fetal intervention and those that did not. In fact, fetal intervention could introduce the associated risks entailed in the interventions [17,18] without proven benefit. One explanation of this discrepancy is that fetuses that underwent fetal intervention were sicker that those who did not (i.e., a selection bias).…”

Section: Discussionmentioning

confidence: 99%

Outcome and Treatment of Antenatally Diagnosed Nonimmune Hydrops Fetalis

et al. 2017

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Introduction: The objectives of this study were to evaluate the outcome of nonimmune hydrops fetalis in an attempt to identify independent predictors of perinatal mortality. Material and Methods: A retrospective cohort study was conducted including all cases of nonimmune hydrops from two tertiary care centers. Perinatal outcome was evaluated after classifying nonimmune hydrops into ten etiological groups. We examined the effect of etiology, site of fluid accumulation, and gestational age at delivery on postnatal survival. Neonatal mortality and hospital discharge survival were compared between the expectant management and fetal intervention groups among those with idiopathic etiology. Results: A total of 142 subjects were available for analysis. Generally, nonimmune hydrops carried 37% risk of neonatal mortality and 50% chance of survival to discharge, which varies markedly based on the underlying etiology. Ascites was an independent predictor of perinatal mortality (p value = 0.003). There was nonsignificant difference in neonatal mortality and hospital discharge survival among idiopathic cases that were managed expectantly versus those in whom fetal intervention was carried out. Discussion: The outcome of nonimmune hydrops varies largely according to the underlying etiology and the presence of ascites is an independent risk factor for perinatal mortality. In our series, fetal intervention did not offer survival advantage among fetuses with idiopathic nonimmune hydrops.

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“…4 Thoracoamniotic shunt (TAS) proved to be effective in treating fetal hydrothorax and preventing fetal hydrops 7,8 ; however, a considerable rate of mechanical complications such as occlusion or displacement has been reported. [9][10][11] Moreover, TAS is a symptomatic treatment and it does not affect the underlying condition.…”

Section: Introductionmentioning

confidence: 99%

Intrauterine Ultrasound-Guided Laser Coagulation as a First Step for Treatment of Prenatally Complicated Bronchopulmonary Sequestration: Our Experience and Literature Review

et al. 2022

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Introduction Prenatal ultrasound-guided laser coagulation (USLC) for complicated bronchopulmonary sequestrations has been described but a consensus on the procedure and on the following management is still lacking. We present our experience and provide a literature review. Methods Retrospective review of patients treated in our center. Literature review and combined analysis of perinatal data were performed. Results Five cases were treated at our center, all presenting with severe hydrothorax. Four met the criteria for fetal hydrops. Four cases underwent postnatal computed tomography (CT) scan: in one case, there was no evidence of persistent bronchopulmonary sequestration. The other three underwent thoracoscopic resection, in two, a viable sequestration was found. Including our series, 57 cases have been reported, with no mortality and a success rate of 94.7%. Mean gestational age (GA) at the procedure was 28 ± 3.4 weeks and mean GA at birth and birth weight (BW) were 38.6 ± 2.3 weeks and 3,276 ± 519.8 g, respectively. In 80.6% of the cases investigated postnatally, a residual mass was found, 50% of cases who showed prenatal arterial flow cessation had a persistent sequestration postnatally, and 26.3% of cases underwent postnatal sequestrectomy. Both patients in our series had pathology examination confirming a viable bronchopulmonary sequestration. Conclusion Prenatal USLC seems to be a valid option for bronchopulmonary sequestration complicated by severe hydrothorax and/or fetal hydrops. Authors believe that this procedure should aim to reverse fetal distress and allow pregnancy continuation, and it should not be considered a definitive treatment. The currently available data do not support changes of the common postnatal management.

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Successful in utero Percutaneous Fetoscopic Release of a Wrapped Pleuro-Amniotic Shunt around the Fetal Arm: Case Report and Review of the Literature

Cited by 6 publications

References 8 publications

Clinical characteristics and neonatal outcomes of liveborn newborns with hydrops fetalis treated in a tertiary level neonatal intensive care unit

Clinical characteristics and neonatal outcomes of liveborn newborns with hydrops fetalis treated in a tertiary level neonatal intensive care unit

Outcome and Treatment of Antenatally Diagnosed Nonimmune Hydrops Fetalis

Intrauterine Ultrasound-Guided Laser Coagulation as a First Step for Treatment of Prenatally Complicated Bronchopulmonary Sequestration: Our Experience and Literature Review

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