Outcomes of fetal intervention for primary hydrothorax

S. Christopher Derderian, Shivika Trivedi, Jody Farrell, Roberta L. Keller, Larry Rand, Ruth Goldstein, Vickie A. Feldstein, Shinjiro Hirose, Tippi C. Mackenzie

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Objective Primary hydrothorax is a rare congenital anomaly with outcomes ranging from spontaneous resolution to fetal demise. We reviewed our experience with fetuses diagnosed with primary hydrothorax to evaluate prenatal management strategies. Methods We reviewed the records of patients evaluated for fetal pleural effusions at our Fetal Treatment Center between 1996 and 2013. To define fetuses with primary hydrothorax, we excluded those with structural or genetic anomalies, diffuse lymphangiectasia, immune hydrops, and monochorionic diamniotic twin gestations. Results We identified 31 fetuses with primary hydrothorax, of whom 24 had hydrops. Hydropic fetuses were more likely to present with bilateral effusions. Of all fetuses with primary hydrothorax, 21 had fetal interventions. Survival without hydrops was 7/7 (100%), whereas survival with hydrops depended on whether or not the patient had fetal intervention: 12/19 (63%) with intervention and 1/5 (20%) without intervention. Premature delivery was common (44%) among those who had fetal intervention. Conclusions Fetal intervention for primary hydrothorax may lead to resolution of hydrops, but preterm birth and neonatal demise still occur. Understanding the pathophysiology of hydrops may provide insights into further prenatal management strategies, including targeted therapies to prevent preterm labor.

Original languageEnglish (US)
Pages (from-to)900-904
Number of pages5
JournalJournal of Pediatric Surgery
Volume49
Issue number6
DOIs
StatePublished - Jan 1 2014

Keywords

  • Congenital chylothorax
  • Hydrops
  • Pleural effusion
  • Primary hydrothorax
  • Thoracoamniotic shunt

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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    Derderian, S. C., Trivedi, S., Farrell, J., Keller, R. L., Rand, L., Goldstein, R., Feldstein, V. A., Hirose, S., & Mackenzie, T. C. (2014). Outcomes of fetal intervention for primary hydrothorax. Journal of Pediatric Surgery, 49(6), 900-904. https://doi.org/10.1016/j.jpedsurg.2014.01.020