Hemodynamic evaluation of a prenatal thoracoamniotic shunt for fetal pleural effusion.
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.
Yonemoto
Hisashi
H
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Japan. yonemoto@med.juntendo.ac.jp
Itoh
Shigeru
S
Nakamura
Yasushi
Y
Yoshida
Koyo
K
Kinoshita
Katsuyuki
K
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