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Thoraco-amniotic shunting.

K H Nicolaides¹, G B Azar

¹Harris Birthright Research Centre for Fetal Medicine, Department of Obstetrics and Gynaecology, King's College Hospital School of Medicine, London, UK.

Fetal Diagnosis and Therapy

|January 1, 1990

Summary

Thoraco-amniotic shunting effectively treats fetal pleural effusions and other thoracic fluid collections. This procedure aids in diagnosis and management, improving survival rates for affected singleton pregnancies.

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Area of Science:

Perinatology
Fetal Medicine
Thoracic Surgery

Background:

Fetal thoracic fluid collections, including pleural effusions, pericardial effusion, and pulmonary cysts, pose significant risks to singleton pregnancies.
Accurate diagnosis and timely intervention are crucial for improving fetal outcomes.

Purpose of the Study:

To evaluate the utility of thoraco-amniotic shunting for the management of fetal intrathoracic fluid collections.
To assess the diagnostic and therapeutic efficacy of this procedure in singleton pregnancies.

Main Methods:

Thoraco-amniotic shunting was performed in 51 singleton pregnancies.
The procedure addressed fetal pleural effusions (n=47), pericardial effusion (n=1), and pulmonary cysts (n=3).
Outcomes were analyzed based on fetal hydrops and chromosomal defects.

Main Results:

Survival rates were higher in non-hydropic fetuses (18/18) compared to those with hydrops (14/28).
Five fetuses had chromosomal defects, and four pregnancies were terminated.
The procedure was useful for diagnostic evaluation and chronic drainage.

Conclusions:

Thoraco-amniotic shunting is a valuable tool for the diagnosis and treatment of fetal intrathoracic fluid collections.
The procedure demonstrates efficacy in improving outcomes for selected singleton pregnancies.
Management strategies should consider fetal hydrops and chromosomal status.

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