Noninvasive management of isolated bilateral fetal hydrothorax

Fetal outcome was studied in eight cases of isolated bilateral fetal hydrothorax. All patients were referred because of polyhydramnios. Spontaneous resolution of pleural effusion was observed twice. No remarkable change in the degree of hydrothorax was demonstrated in the remaining six cases. All eight cases resulted in the birth of a live infant without other abnormalities. Postnatal intubation, which was carried out in all six fetuses with hydrothorax, was always followed by spontaneous respiration. Subsequent thoracocentesis resulted in the collection of 50 to 500 ml of serous fluid. Sustained intubation (7 days) was necessary in only two infants because of developing respiratory distress as a result of prematurity or recurrent pleural fluid accumulation. All eight infants were alive and well at the age of 1 month. Although in the present study noninvasive management of isolated fetal hydrothorax seems to have been justified, a larger multicenter study is needed to compare survival with and without pleuroamniotic shunting.