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Respiratory function in infancy following pleuro-amniotic shunting
P J Thompson1, A Greenough, K H Nicolaides
1Department of Child Health, King's College Hospital, London, UK.
Fetal Diagnosis and Therapy
|March 1, 1993
Summary
Pleuro-amniotic shunting effectively drained fetal pleural effusions, preventing lung growth impairment. Post-procedure respiratory outcomes in infants were comparable to controls, indicating safety and efficacy.
Area of Science:
- Perinatology
- Pediatric Pulmonology
- Fetal Surgery
Background:
- Fetal pleural effusions can lead to chronic antenatal intrathoracic compression.
- Such compression may impair fetal lung development and impact postnatal respiratory function.
- Pleuro-amniotic shunting is a potential intervention to manage these effusions.
Purpose of the Study:
- To evaluate the effectiveness of pleuro-amniotic shunting in draining fetal pleural effusions.
- To assess the long-term respiratory status of infants following fetal pleural effusion drainage.
- To determine if pleuro-amniotic shunting prevents impaired antenatal lung growth.
Main Methods:
- Retrospective review of 17 infants undergoing pleuro-amniotic shunting for fetal pleural effusions.
- Shunt insertion occurred at a median of 29 weeks gestation.
- Respiratory status assessed via symptom documentation and functional residual capacity (FRC) measurement at a median of 12 months post-procedure.
Main Results:
- Effective chronic drainage of pleural effusions was achieved in all 17 cases.
- 37% of infants experienced recurrent respiratory symptoms, a rate not significantly different from controls.
- Mean FRC was within the normal range for 15 out of 17 infants.
Conclusions:
- Pleuro-amniotic shunting is an effective method for draining fetal pleural effusions.
- The procedure appears to prevent chronic antenatal intrathoracic compression without causing significant long-term respiratory impairment.
- This intervention may help avoid impaired antenatal lung growth.