Fetal Cardiac Tamponade in a Case of Right-Side Congenital Diaphragmatic Hernia

Bahram Salmanian, Alireza A. Shamshirsaz, Darrell L. Cass, Pouya Javadian, Rodrigo Ruano, Nancy A. Ayres, Amy Mehollin-Ray, Michael A. Belfort

Research output: Contribution to journalComment/debate

Abstract

BACKGROUND:: Intrafetal fluid collection is a rare ultrasound finding in fetuses with right-side congenital diaphragmatic hernia. CASE:: Our patient had a fetus with a large right-side congenital diaphragmatic hernia with a significant amount of the fetal liver herniated into the chest. At 31 weeks of gestation, the fetus had significant ascites and high-pressure intrathoracic fluid accumulation, hydrops fetalis, deviation of the mediastinum, and tamponade-like physiology that compromised cardiac function. Ultrasound-guided fetal thoracoamniotic and peritoneal amniotic shunt placement markedly improved the fetal cardiac function and resolved the hydrops. The patient delivered at 34 weeks of gestation because of preterm labor and the neonate had an uncomplicated diaphragmatic hernia repair 3 days after delivery. CONCLUSION:: Fetal thoracoamniotic shunting in selected cases of congenital diaphragmatic hernia with hydrops may improve the prognosis.

Original languageEnglish (US)
Pages (from-to)447-450
Number of pages4
JournalObstetrics and Gynecology
Volume123
Issue number2 PART 2
DOIs
StatePublished - Jan 13 2014
Externally publishedYes

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Cardiac Tamponade
Fetus
Edema
Hydrops Fetalis
Pregnancy
Premature Obstetric Labor
Herniorrhaphy
Mediastinum
Ascites
Thorax
Newborn Infant
Pressure
Liver
Congenital Diaphragmatic Hernias

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Salmanian, B., Shamshirsaz, A. A., Cass, D. L., Javadian, P., Ruano, R., Ayres, N. A., ... Belfort, M. A. (2014). Fetal Cardiac Tamponade in a Case of Right-Side Congenital Diaphragmatic Hernia. Obstetrics and Gynecology, 123(2 PART 2), 447-450. https://doi.org/10.1097/AOG.0000000000000098

Fetal Cardiac Tamponade in a Case of Right-Side Congenital Diaphragmatic Hernia. / Salmanian, Bahram; Shamshirsaz, Alireza A.; Cass, Darrell L.; Javadian, Pouya; Ruano, Rodrigo; Ayres, Nancy A.; Mehollin-Ray, Amy; Belfort, Michael A.

In: Obstetrics and Gynecology, Vol. 123, No. 2 PART 2, 13.01.2014, p. 447-450.

Research output: Contribution to journalComment/debate

Salmanian, B, Shamshirsaz, AA, Cass, DL, Javadian, P, Ruano, R, Ayres, NA, Mehollin-Ray, A & Belfort, MA 2014, 'Fetal Cardiac Tamponade in a Case of Right-Side Congenital Diaphragmatic Hernia', Obstetrics and Gynecology, vol. 123, no. 2 PART 2, pp. 447-450. https://doi.org/10.1097/AOG.0000000000000098
Salmanian B, Shamshirsaz AA, Cass DL, Javadian P, Ruano R, Ayres NA et al. Fetal Cardiac Tamponade in a Case of Right-Side Congenital Diaphragmatic Hernia. Obstetrics and Gynecology. 2014 Jan 13;123(2 PART 2):447-450. https://doi.org/10.1097/AOG.0000000000000098
Salmanian, Bahram ; Shamshirsaz, Alireza A. ; Cass, Darrell L. ; Javadian, Pouya ; Ruano, Rodrigo ; Ayres, Nancy A. ; Mehollin-Ray, Amy ; Belfort, Michael A. / Fetal Cardiac Tamponade in a Case of Right-Side Congenital Diaphragmatic Hernia. In: Obstetrics and Gynecology. 2014 ; Vol. 123, No. 2 PART 2. pp. 447-450.
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AB - BACKGROUND:: Intrafetal fluid collection is a rare ultrasound finding in fetuses with right-side congenital diaphragmatic hernia. CASE:: Our patient had a fetus with a large right-side congenital diaphragmatic hernia with a significant amount of the fetal liver herniated into the chest. At 31 weeks of gestation, the fetus had significant ascites and high-pressure intrathoracic fluid accumulation, hydrops fetalis, deviation of the mediastinum, and tamponade-like physiology that compromised cardiac function. Ultrasound-guided fetal thoracoamniotic and peritoneal amniotic shunt placement markedly improved the fetal cardiac function and resolved the hydrops. The patient delivered at 34 weeks of gestation because of preterm labor and the neonate had an uncomplicated diaphragmatic hernia repair 3 days after delivery. CONCLUSION:: Fetal thoracoamniotic shunting in selected cases of congenital diaphragmatic hernia with hydrops may improve the prognosis.

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