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% ,re-spectively,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.