Adams Tracy M, Kunzier Nadia B, Chavez Martin R, Vintzileos Anthony M
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Stony Brook University Hospital, Mineola, N.Y., USA.
Fetal Diagn Ther. 2016;39(1):78-80. doi: 10.1159/000371576. Epub 2015 Feb 6.
Untreated fetal pleural effusion can cause significant perinatal morbidity and mortality. Treatment of pleural effusions with pleuro-amniotic shunting has been shown to improve outcomes. Pleuro-amniotic shunting is associated with complications including ruptured membranes, preterm labor and shunt dislodgement into either the amniotic cavity or the fetal thorax. Shunt dislodgement into the thoracic cavity can cause prenatal complications from the shunt itself or may necessitate neonatal surgery for removal. We present a case where a novel ultrasound-guided technique was used to replace the dislodged pleural shunt in utero, thereby effectively draining the effusion while simultaneously obviating the need for neonatal surgery and decreasing possible perinatal complications.
未经治疗的胎儿胸腔积液可导致显著的围产期发病率和死亡率。已证明采用羊膜腔分流术治疗胸腔积液可改善预后。羊膜腔分流术会伴有包括胎膜破裂、早产以及分流管移位至羊膜腔或胎儿胸腔等并发症。分流管移位至胸腔可因分流管本身导致产前并发症，或者可能需要进行新生儿手术以取出分流管。我们报告了一例病例，其中采用了一种新型超声引导技术在子宫内更换移位的胸腔分流管，从而有效引流积液，同时避免了新生儿手术的需要并减少了可能的围产期并发症。
