Wang X Q, Li W J, Yan R L, Xiang J W, Liu M Y
Fetal Medicine Department, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
Zhonghua Fu Chan Ke Za Zhi. 2018 Feb 25;53(2):82-87. doi: 10.3760/cma.j.issn.0529-567X.2018.02.003.
To optimize the clinical managements of primary fetal hydrothorax (PFHT) fetus by comparing the perinatal survival rate of different prenatal treatments. Totally 13 fetuses diagnosed with PFHT from July 2009 to December 2015 in the First Affiliated Hospital of Jinan University were collected and received prenatal expectant treatment, thoracocentesis (TC), and thoraco-amniotic shunting (TAS), respectively. The perinatal survival rate was compared among the three treatments. Among 13 fetuses of PFHT, pleural effusion was absorbed or remained stable in 2(2/13) cases, and progressed in 11(11/13) cases. Six cases received expectant treatment (2 cases had termination of pregnancy due to progressing effusion, 2 cases had term delivery, and 2 cases had intrauterine death); the perinatal survival rate was 2/6. Six cases received TC (2 cases had term delivery, 2 cases had preterm delivery, and 2 cases had termination of pregnancy due to progressing effusion), the perinatal survival rate was 4/6. One case received TC+TAS (term delivery), the perinatal survival rate was 1/1. The overall perinatal survival rate of prenatal intrauterine intervention was 5/7. The clinical process of PFHT is changeable, and the pleural effusion will progress with gestational age. Intrauterine interventions could improve the perinatal survival rate.
通过比较不同产前治疗方法的围产期生存率，优化原发性胎儿胸腔积液（PFHT）胎儿的临床管理。收集2009年7月至2015年12月在暨南大学附属第一医院诊断为PFHT的13例胎儿，分别接受产前期待治疗、胸腔穿刺术（TC）和胸腔羊膜分流术（TAS）。比较三种治疗方法的围产期生存率。在13例PFHT胎儿中，2例（2/13）胸腔积液吸收或保持稳定，11例（11/13）进展。6例接受期待治疗（2例因积液进展而终止妊娠，2例足月分娩，2例宫内死亡）；围产期生存率为2/6。6例接受TC（2例足月分娩，2例早产，2例因积液进展而终止妊娠），围产期生存率为4/6。1例接受TC+TAS（足月分娩），围产期生存率为1/1。产前宫内干预的总体围产期生存率为5/7。PFHT的临床过程多变，胸腔积液会随着孕周进展。宫内干预可提高围产期生存率。
