Fetal pleural effusion: a review and meta-analysis for prognostic indicators

We reviewed the literature on fetal pleural effusion to identify prognostic indicators related to outcome. Data on 124 cases from 38 reports were collected and analyzed using chi 2 statistical analysis and stepwise multiple logistic regression. Termination of pregnancy occurred in ten cases, spontaneous resolution occurred in 11 cases with 100% survival, and overall mortality was 46%. Gestational age at delivery of greater than 31 weeks, the absence of hydrops, and the use of antenatal therapy (thoracentesis or shunt placement) were associated with good outcome. Gender of the fetus, hydramnios, extent of effusion as unilateral or bilateral, and mode of delivery were not significantly related to outcome. Recommendations for evaluation include search for other abnormalities and possible causes related to hydrops. Management is guided by gestational age and the presence of hydrops. Antenatal therapy is recommended if hydrops develops, particularly at a gestational age of less than 32 weeks.