Drainage thoraco-amniotique en urgence en cas d'épanchement pleural compressif responsable d'anasarque fœtale: Une série rétrospective de 60 cas

Translated title of the contribution: Emergency thoraco amniotic shunting in cases with compressive pleural effusion with hydrops: A retrospective study of 60 cases

O. Picone, A. Benachi, L. Mandelbrot, Rodrigo Ruano, Y. Dumez, M. Dommergues

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives. To study perinatal outcome following thoraco-amniotic shunting for fetal pleural effusions with hydrops. Matérials and methods. Retrospective study (1984-2004) to evaluate a policy of emergency thracoamniotic shunting in hydropic fetuses with suspected chylothorax, on the basis of the rationale that mediastinal compression could lead to acute fetal distress. Results. Shunting was performed immediately following diagnosis, and was successful in all 60 cases attempted. There were 7 pregnancy terminations, 10 in utero deaths, and 43 live births, of which 7 children died in the neonatal period and 36 survived (33 without sequels). Among the liveborn, 26 were delivered preterm (72%), of which 7 (19%) had preterm premature rupture of membranes and 4 (11%) had chorioamnionitis. Perinatal death (24/60, 40%) was related to underlying anomalies (7 cases), pulmonary hypoplasia (5 cases), chorioamnionitis (2 cases), or treatment failure for unknown reasons (10 cases). All 36 survivors had chylothorax, 33 of which were primary, and 3 were secondary to right congenital diaphragmatic hernia, pulmonary sequestration, or Noonan syndrome. Conclusion. Following shunting, pleural effusion with hydrops has survival rate >50%, but still have a high rate of morbidity and mortality.

Original languageFrench
Pages (from-to)652-657
Number of pages6
JournalJournal de Gynecologie Obstetrique et Biologie de la Reproduction
Volume35
Issue number7
StatePublished - Jan 1 2006
Externally publishedYes

Fingerprint

Pleural Effusion
Chylothorax
Chorioamnionitis
Edema
Emergencies
Retrospective Studies
Noonan Syndrome
Bronchopulmonary Sequestration
Fetal Distress
Live Birth
Treatment Failure
Survivors
Fetus
Survival Rate
Outcome Assessment (Health Care)
Morbidity
Pregnancy
Lung
Mortality

Keywords

  • Chylothorax
  • Hydrops
  • Pleural effusion
  • Thoraco amniotic shunt

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Drainage thoraco-amniotique en urgence en cas d'épanchement pleural compressif responsable d'anasarque fœtale : Une série rétrospective de 60 cas. / Picone, O.; Benachi, A.; Mandelbrot, L.; Ruano, Rodrigo; Dumez, Y.; Dommergues, M.

In: Journal de Gynecologie Obstetrique et Biologie de la Reproduction, Vol. 35, No. 7, 01.01.2006, p. 652-657.

Research output: Contribution to journalArticle

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abstract = "Objectives. To study perinatal outcome following thoraco-amniotic shunting for fetal pleural effusions with hydrops. Mat{\'e}rials and methods. Retrospective study (1984-2004) to evaluate a policy of emergency thracoamniotic shunting in hydropic fetuses with suspected chylothorax, on the basis of the rationale that mediastinal compression could lead to acute fetal distress. Results. Shunting was performed immediately following diagnosis, and was successful in all 60 cases attempted. There were 7 pregnancy terminations, 10 in utero deaths, and 43 live births, of which 7 children died in the neonatal period and 36 survived (33 without sequels). Among the liveborn, 26 were delivered preterm (72{\%}), of which 7 (19{\%}) had preterm premature rupture of membranes and 4 (11{\%}) had chorioamnionitis. Perinatal death (24/60, 40{\%}) was related to underlying anomalies (7 cases), pulmonary hypoplasia (5 cases), chorioamnionitis (2 cases), or treatment failure for unknown reasons (10 cases). All 36 survivors had chylothorax, 33 of which were primary, and 3 were secondary to right congenital diaphragmatic hernia, pulmonary sequestration, or Noonan syndrome. Conclusion. Following shunting, pleural effusion with hydrops has survival rate >50{\%}, but still have a high rate of morbidity and mortality.",
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