title: Hemodynamic evaluation of a prenatal thoracoamniotic shunt for fetal pleural effusion.
abstract: OBJECTIVE
  To evaluate the efficacy of a thoracoamniotic shunt for the treatment of pleural effusion (PE) in the view of hemodynamics.
  
  
  METHODS
  The preload index (PLI) in the inferior vena cava (IVC), the maximal flow velocity of the descending aorta (VAomax), skin edema on the thorax and the ratio of lung to the thorax transverse area (L/T) as measured by ultrasound were evaluated before and after thoracoamniotic shunt placement for 5 fetuses with PE.
  
  
  RESULTS
  The PLI and skin edema on the thorax decreased significantly after shunt placement compared to before shunt placement (PLI before: 0.488 +/- 0.036, after: 0.348 +/- 0.043, P < 0.05; edema before: 15.3 +/- 2.06 mm, after: 9.00 +/- 0.63 mm, P < 0.05). Furthermore, the L/T increased significantly after shunt placement compared to before (before: 0.220 +/- 0.013, after: 0.260 +/- 0.011, P < 0.01). No significant difference in VAomax was seen between before and after shunt placement (before: 101.5 +/ -6.39 cm/s, after: 10.7.6 +/ -5.41 cm/s, P = 0.16).
  
  
  CONCLUSIONS
  The shunt for PE improved PLI especially in the fetal hemodynamics significantly.
authors.affiliation: Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Japan. yonemoto@med.juntendo.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yonemoto
authors.forename: Shigeru
authors.initials: S
authors.lastname: Itoh
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Koyo
authors.initials: K
authors.lastname: Yoshida
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D000650:Amnion / Q000601:surgery*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005865:Gestational Age; D006439:Hemodynamics / Q000502:physiology; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D010996:Pleural Effusion / Q000151:congenital / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013907:Thoracostomy / Q000379:methods*; D016216:Ultrasonography, Prenatal