[Prenatal diagnosis and therapy of hydro-/chylothorax with fetal hydrops]

The prenatal diagnosis of a massive bilateral hydro-/chylothorax at 34 weeks of gestation is presented. It was associated with a marked hydrops which probably had resulted from protein depletion into the pleural cavity and/or elevation of intrathoracic pressure with subsequent obstruction of venous return. So the hydro-/chylothorax is to be considered a further cause of the congenital hydrops universalis. After induction of lung maturation with dexamethasone the infant was delivered by a primary cesarean section at 36 weeks of pregnancy. The immediately following intensive care guaranteed the circulatory function and ventilation. The pleural effusions were managed successfully by careful continuous intrapleural drainage and intravenous protein substitution. Last not least, the survival of the infant despite the massive findings is to be owed to the close cooperation of pediatricians and obstetricians.