Congenital chylothorax: a case report.
A case of unilateral congenital hydrothorax diagnosed at 21 weeks and treated with a pleuro-amniotic shunt at 23 weeks' gestation is presented. The rapid production of pleural fluid led to the development of polyhydramnios which was treated with a selective Cox inhibitor. Due to worsening of the hydrothorax, a third thoracocentesis was performed at 30 weeks' gestation prior to a Cesarean section. The neonate responded well to mechanical ventilation, a thoracic drainer that was inserted between days 5 and 14, fluid and protein replacement and gradual transition from parenteral to intestinal nutrition. Early diagnosis of chylothorax should be treated by thoraco-amniotic drainage to prevent fetal pulmonary hypoplasia and congestive cardiac failure. Polyhydramnios is a complication of this therapy and may require treatment with a Cox inhibitor.
Brito
T
T
Department of Obstetrics and Gynaecology, Gaia Hospital, Gaia, Portugal. obstet@chvng.pt
Oliveira
C
C
Sousa
L
L
Barbosa
A
A
Pinho
O
O
Mesquita
M
M
Pinto
R
R
Inocêncio
A
A
Valente
F
F
D000328:Adult; D002585:Cesarean Section; D002916:Chylothorax / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D004322:Drainage; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D006876:Hydrothorax / Q000209:etiology; D007231:Infant, Newborn; D008297:Male; D010996:Pleural Effusion / Q000209:etiology / Q000601:surgery; D018700:Pleurodesis / Q000379:methods; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D014463:Ultrasonography