Perinatal outcome of 71 cases of primary fetal pleural effusion / 中华实用儿科临床杂志

ABSTRACT

Objective@#To explore the perinatal outcome of antenatally diagnosed primary fetal hydrothorax (FHT), and to provide management experience for FHT.@*Methods@#The clinical data of 80 cases with FHT, from January 2014 to February 2018 in Guangdong Women and Children Hospital, were retrospectively analyzed.@*Results@#Among 80 cases of FHT, the median age of the pregnant women was 29 years old (24-33 years old), while the median gestational age at diagnosis was 29+ 1 weeks(24-32 weeks), among them, 9 cases were lost to follow-up.Among the other 71 cases, 48 cases(67.6%) developed fetal edema, 44 cases (62.0%) involved bilateral pleural effusion, and 35 cases (49.3%) were associated with polyhydramnios.The rate of thoracoamniotic shunting and thoracentesis were 29.6% (21/71 cases) and 7.0% (5/71 cases), respectively.Among 71 cases of FHT, the overall survival rate was 63.4% (45/71 cases), the rate of termination of pregnancy was 22.5% (16/71 cases), including 2 cases which were chosen for termination of pregnancy after thoracoamniotic shunting due to poor control.Among the 55 continued gestation cases, 7 cases died in uterus, and the survival rate of fetal hydropic cases and non-hydropic cases was 70.6% and 100.0%, respectively, and the difference was statistically significant(P<0.05). Among the 48 cases of hydropic cases, there were 34 cases (70.8%) chosen to continue the pregnancy, the survival rate of non-intervention group (13 cases), thoracentesis group (4 cases) and thoracoamniotic shunting group (17 cases) were 53.8%, 75.0% and 82.4%, respectively, and the difference was statistically significant (P<0.05).@*Conclusions@#Fetal hydrops predicted a poor prognosis in PFHT.Timely intrauterine intervention could effectively improve the prognosis of PFHT and improve the survival rate.