Nygaard Ulrikka, Sundberg Karin, Nielsen Henriette Svarre, Hertel Steen, Jørgensen Connie
Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Obstet Gynecol. 2007 May;109(5):1088-92. doi: 10.1097/01.AOG.0000259907.91973.69.
To evaluate OK-432, a preparation of Streptococcus pyogenes, in the treatment of early fetal chylothorax.
A prospective study of all fetuses (n=7) with persistent early chylothorax (gestational ages 16-21 weeks) referred to the tertiary center of fetal medicine in Denmark in 2003-2005. Fetuses were injected with 0.2-1.0 mg of OK-432 into the pleural cavity. The treatment was repeated if there were persistent or increasing pleural effusions after 1-3 weeks. The main outcome measures included remission of pleural effusions and fetal and infant morbidity and mortality.
Total remission of pleural effusions was obtained in all fetuses after one or two intrapleural injections of OK-432. No adverse effects of the treatment were observed. No fetus developed hydrops, and all experienced an uncomplicated third trimester. All children were born healthy without pleural effusions, lung hypoplasia, or hydrops.
Persistent early chylothorax is a condition with a high mortality rate and no established treatment option. Use of OK-432 is a promising therapy for selected fetuses with persistent chylothorax early in the second trimester.
评估化脓性链球菌制剂溶链菌制剂（OK-432）治疗早期胎儿乳糜胸的效果。
对2003年至2005年转诊至丹麦胎儿医学三级中心的所有持续性早期乳糜胸胎儿（n = 7，孕龄16 - 21周）进行前瞻性研究。向胎儿胸腔内注射0.2 - 1.0毫克OK-432。如果在1 - 3周后存在持续性或增多的胸腔积液，则重复该治疗。主要观察指标包括胸腔积液的缓解情况以及胎儿和婴儿的发病率和死亡率。
所有胎儿在胸腔内注射一或两次OK-432后胸腔积液完全缓解。未观察到该治疗的不良反应。没有胎儿发生水肿，所有胎儿在孕晚期均经历了无并发症的过程。所有儿童出生时均健康，无胸腔积液、肺发育不全或水肿。
持续性早期乳糜胸是一种死亡率高且尚无既定治疗方案的疾病。对于孕中期早期患有持续性乳糜胸的特定胎儿，使用OK-432是一种有前景的治疗方法。
