title: Thoracoamniotic shunting for fetal pleural effusions with hydrops.
abstract: OBJECTIVE
  The purpose of this study was to evaluate perinatal outcome after thoracoamniotic shunting for fetal pleural effusions with hydrops.
  
  
  METHODS
  This was a retrospective study.
  
  
  RESULTS
  Shunting was performed immediately after diagnosis and was successful in all 54 of the cases that were attempted. There were 7 pregnancy terminations, 9 in utero deaths, and 38 live births, of which 7 children died in the neonatal period and 31 children survived. Among the liveborn infants, 27 infants were delivered preterm (71%), of whom 7 infants (15%) had preterm premature rupture of membranes and 4 infants (8.5%) had chorioamnionitis. Perinatal death (23/54 infants; 43%) was related to underlying anomalies (7 cases), pulmonary hypoplasia (5 cases), chorioamnionitis (2 cases), or treatment failure for unknown reasons (9 cases). All 31 survivors had chylothorax; for 28 of the survivors, the chylothorax was primary, and for 3 survivors, the chylothorax was the result of right congenital diaphragmatic hernia, pulmonary sequestration, or Noonan syndrome.
  
  
  CONCLUSIONS
  After the shunting, pleural effusion with hydrops has a 57% survival rate; premature delivery is the leading source of morbidity.
authors.affiliation: Hôpital Necker-Enfants Malades, AP-HP and Université Paris V, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Picone
authors.forename: Alexandra
authors.initials: A
authors.lastname: Benachi
authors.forename: Laurent
authors.initials: L
authors.lastname: Mandelbrot
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ruano
authors.forename: Yves
authors.initials: Y
authors.lastname: Dumez
authors.forename: Marc
authors.initials: M
authors.lastname: Dommergues
mesh_terms: D000653:Amniotic Fluid; D015331:Cohort Studies; D004322:Drainage / Q000379:methods; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006876:Hydrothorax / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013907:Thoracostomy / Q000379:methods; D016216:Ultrasonography, Prenatal