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Congenital chylothorax: from foetal life to adolescence

S Caserío1, C Gallego, P Martin

  • 1Department of Pediatrics, Hospital Universitario "12 de Octubre", Madrid, Spain. caseriocs@hotmail.com

Acta Paediatrica (Oslo, Norway : 1992)
|June 10, 2010
PubMed

Insights

Congenital chylothorax (CC) often presents prenatally and impacts survival, particularly with complications like fetal hydrops. However, advances in neonatal care are improving outcomes for affected infants.

Area of Science:

  • Perinatal Medicine
  • Neonatology
  • Pediatric Surgery

Background:

  • Congenital chylothorax (CC) is a rare condition characterized by lymphatic fluid accumulation in the pleural space.
  • Prenatal diagnosis and understanding associated complications are crucial for management.
  • The prognosis of CC has historically been guarded, necessitating improved therapeutic strategies.

Purpose of the Study:

  • To analyze the key prenatal and postnatal features of congenital chylothorax (CC).
  • To evaluate the outcomes and mid-term follow-up of infants diagnosed with CC.
  • To identify factors influencing survival rates in CC patients.

Main Methods:

  • Retrospective analysis of 29 CC cases diagnosed between 1990 and 2006.
  • Inclusion of prenatal and postnatal data, including complications and interventions.
  • Follow-up data available up to 3 years of age for all patients.

Main Results:

  • Most CC cases (94%) were diagnosed prenatally, with 66.7% complicated by fetal hydrops.
  • Overall 3-year survival rate was 56%, significantly lower with fetal hydrops, preterm birth (<34 weeks), large effusions, or early pneumothorax.
  • While not statistically significant, survival improved from 41.7% (1990-1998) to 66.7% (1999-2006).
  • Mid-term follow-up showed no CC recurrence, but 27% of survivors developed asthma.

Conclusions:

  • Congenital chylothorax (CC) continues to pose a significant risk of perinatal mortality.
  • Advances in fetal and neonatal medicine are improving CC patient prognosis, with most now expected to survive.
  • Survivors generally experience an uneventful outcome post-neonatal period, though early childhood asthma is a noted concern.
Abstract

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