The outcomes and prognostic factors of fetal hydrothorax associated with trisomy 21

Yumoto, Yasuo; Jwa, Seung Chik; Wada, Seiji; Takahashi, Yuichiro; Ishii, Keisuke; Kato, Kiyoko; Usui, Noriaki; Sago, Haruhiko

doi:10.1002/pd.5066

Cited by 12 publications

(13 citation statements)

References 22 publications

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“…In Japan, VAS has been performed for fetuses with LUTO using a double-basket catheter since the 1990s. 8 Thoracoamniotic shunting for fetal hydrothorax using the same double-basket catheter has been intensively investigated [9][10][11][12] and it is established as a standard prenatal care in Japan. 13 In contrast, VAS was poorly researched and the outcomes of prenatally diagnosed LUTO remain unclear in Japan.…”

Section: Introductionmentioning

confidence: 99%

Prenatally diagnosed lower urinary tract obstruction: A 15‐year experience at two tertiary centers in Japan

Sugibayashi

Wada

Ozawa

et al. 2021

J of Obstet and Gynaecol

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Aim: To examine the outcomes of prenatally diagnosed lower urinary tract obstruction (LUTO) with current management using vesicoamniotic shunting (VAS). Methods: A retrospective study of prenatally diagnosed LUTO before 26 weeks of gestation at two tertiary centers in Japan between March 2002 and September 2017. LUTO was diagnosed by ultrasound demonstration of an enlarged fetal bladder associated with hydronephrosis and/or hydroureters. VAS was offered for fetuses with LUTO at ≤26 weeks of gestational age, in the presence of oligohydramnios or decreasing amniotic fluid and a favorable fetal urinary analysis. Results: Among 87 fetuses with LUTO, 46 (53%) were terminated before 22 weeks of gestation. Eight cases (9%) underwent VAS and one underwent fetoscopic urethrotomy. The live birth rates in the VAS and expectant groups were 100% (8/8) and 56% (18/32), respectively (p = 0.034), and the survival rates at 6 months old with a normal renal function were 38% (3/8) and 16% (5/32), respectively (p = 0.608). The etiology varied with six cases of associated anomalies among 23 diagnosed cases. Among the nine cases of posterior urethral valve (PUV), only one fetus underwent VAS at 25 weeks of gestation, ultimately surviving with mild renal dysfunction. Among the other eight cases of PUV that were managed expectantly, two died, and only one of the six survivors showed a normal renal function. Conclusions: More than half of the prenatally diagnosed LUTO cases were terminated. VAS seemed effective for achieving a perinatal survival, regardless of etiology. The outcomes were poor in cases of expectantly managed PUV.

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Section: Introductionmentioning

confidence: 99%

Prenatally diagnosed lower urinary tract obstruction: A 15‐year experience at two tertiary centers in Japan

Sugibayashi

Wada

Ozawa

et al. 2021

J of Obstet and Gynaecol

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“…In neonates with trisomy 21 complicated with lymphatic dysplasia, the prognosis of chylous effusion has been reported to be mildly poorer than those without chromosomal aberration. 11 Because it requires weeks or even months to achieve remission for chylous effusion, it is necessary to establish an oral administrative pharmacotherapy that could be continued at home, to make it possible for the patients to go home a little earlier and, of course, safely.…”

Section: Discussionmentioning

confidence: 99%

Midodrine, an Oral Alpha-1 Adrenoreceptor Agonist, Successfully Treated Refractory Congenital Chylous Pleural Effusion and Ascites in a Neonate

Tamaoka

Osada

Kin

et al. 2021

Chest

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A trisomy 21 neonate presented with congenital chylous pleural effusion and ascites that was refractory to conventional pharmacotherapy. Midodrine, an oral alpha-1-adrenoreceptor agonist, achieved remission of chylous effusion without any adverse effects. To the best of our knowledge, this is the first neonatal case of successful management of congenital chylous pleural effusion and ascites with midodrine.

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“…Los resultados perinatales empeoran por malformaciones asociadas (hasta 25%) y aneuploidía (7 a 12% de todos los casos) (7,8) . La mayoría de los casos son leves (9) , pero los casos graves se producen cuando el líquido se expande por más de 50% del tórax. El derrame pleural grave se asocia con una elevada morbimortalidad perinatal, que es mucho más alta en presencia de hidropesía fetal (10) .…”

Section: Discussionunclassified

Derivación toracoamniótica en hidrotórax fetal: reporte de un caso

Tacchino

Sifuentes²,

Estrada³

et al. 2019

Rev peru ginecol obstet.

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Presentamos un caso de hidrotórax masivo unilateral diagnosticado a las 18 semanas de gestación en un feto con cariotipo normal. El feto fue afectado severamente por hydrops y bradicardia desde las 24 semanas. Inicialmente realizamos una pleurodesis, pero debido al empeoramiento del hidrotórax que evolucionó a hidropesía, procedimos con la inserción de una derivación toracoamniótica transplacentaria. La mejoría fue evidente una semana después del procedimiento, seguido por la resolución del hidrotórax durante el resto del embarazo. Después de una cesárea a las 37 semanas, el neonato requirió una estancia prolongada en la UCIN. Fue dado de alta a los 2 meses de edad y se ha mantenido estable hasta el momento actual.

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The outcomes and prognostic factors of fetal hydrothorax associated with trisomy 21

Cited by 12 publications

References 22 publications

Prenatally diagnosed lower urinary tract obstruction: A 15‐year experience at two tertiary centers in Japan

Prenatally diagnosed lower urinary tract obstruction: A 15‐year experience at two tertiary centers in Japan

Midodrine, an Oral Alpha-1 Adrenoreceptor Agonist, Successfully Treated Refractory Congenital Chylous Pleural Effusion and Ascites in a Neonate

Derivación toracoamniótica en hidrotórax fetal: reporte de un caso

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