Outcome of fetal pleural effusions treated by thoracoamniotic shunting.
OBJECTIVE
Fetal pleural effusions are uncommon, and treatment options for moderate or severe effusions include drainage and thoracoamniotic shunting. However, relatively few records of effusions treated by thoracoamniotic shunting are available in the literature, so our objective was to study the outcome after thoracoamniotic shunting in our unit.


METHODS
We searched the database of our tertiary fetal medicine unit for all cases of fetal pleural effusion treated by thoracoamniotic shunting between 1997 and 2003 inclusive, and studied the maternal and neonatal records.


RESULTS
Ninety-two cases of fetal pleural effusion were studied, of which 21 had undergone a thoracoamniotic shunt. Sixteen of these 21 fetuses (76%) had associated hydrops, of which seven (44%) survived and, of the five (24%) without associated hydrops, three (60%) survived. There were two procedure-related losses. No shunted cases were associated with abnormal karyotype or proven maternal infection, but it is probable that three cases had been caused by an underlying genetic syndrome.


CONCLUSIONS
The survival of fetuses with severe pleural effusions after thoracoamniotic shunting in this study was 48%.
Smith
R P
RP
Fetal Medicine Research Unit, University of Bristol, St Michael's Hospital, Bristol, UK. richardp.smith@ubht.swest.nhs.uk
Illanes
S
S
Denbow
M L
ML
Soothill
P W
PW
D000653:Amniotic Fluid; D000714:Anastomosis, Surgical; D004322:Drainage / Q000379:methods; D005260:Female; D005313:Fetal Death; D006801:Humans; D015160:Hydrops Fetalis / Q000401:mortality / Q000601:surgery*; D010996:Pleural Effusion / Q000196:embryology / Q000401:mortality / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013909:Thorax