title: Thoracoamniotic shunting for fetal pleural effusions using a double-basket shunt.
abstract: OBJECTIVE
  To describe the safety and efficacy of thoracoamniotic shunting for fetal pleural effusion using a double-basket catheter with a very small diameter (1.47 mm).
  
  
  METHODS
  In this 2-year multicenter, prospective single-arm clinical study registered with the University hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN00001095); shunting was performed between 18w0d and 33w6d of gestation with this catheter in cases of fetal pleural effusions reaccumulating after thoracocentesis. The primary endpoint measures were maternal and fetal adverse effects and survival in the neonatal period.
  
  
  RESULTS
  A total of 24 cases were included, of which 17 had hydrops (71%). The median gestational ages at shunting and delivery were 27.4 and 34.8 weeks, respectively. There were no fetal deaths, lung injuries, or severe maternal complications. Preterm rupture of the membranes occurred in 7/24 (29%) cases at a median of 62 days after the shunting. Preterm rupture of the membranes within 28 days of the procedure occurred in 1/24 (4%) cases. Catheter displacement towards the fetal thoracic cavity occurred in 4/42 (10%) cases. The overall survival rate was 79% (19/24), whereas it was 71% (12/17) in the cases with hydrops.
  
  
  CONCLUSIONS
  Drainage of fetal pleural effusions with a double-basket shunt is safe and effective, and the shunt could be an alternative device.
authors.affiliation: Department of Fetal-Maternal Medicine, Nagara Medical Center, Gifu, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawabata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sumie
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nakata
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ishii
authors.forename: Takeshi
authors.initials: T
authors.lastname: Murakoshi
authors.forename: Shinji
authors.initials: S
authors.lastname: Katsuragi
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Mari
authors.initials: M
authors.lastname: Saito
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hayashi
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sago
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D046128:Fetal Therapies / Q000009:adverse effects; D006801:Humans; D015160:Hydrops Fetalis / Q000401:mortality / Q000601:surgery*; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D010996:Pleural Effusion / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies; D055815:Young Adult