胎儿胸腔羊膜分流术治疗宫内先天性乳糜胸：病例报告。
In utero congenital chylothorax treatment with fetal thoracoamniotic shunt: Case report.
机构信息
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine; The Medical Center Navicent Health, Mercer University School of Medicine, Macon, GA, USA.
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine; Emory University School of Medicine, Atlanta, GA, USA.
出版信息
J Neonatal Perinatal Med. 2020;13(3):427-430. doi: 10.3233/NPM-190235.
BACKGROUND
Fetal pleural effusions are a rare fetal anomaly that may result from congenital chylothorax. Severe cases lead to chest compression with resulting pulmonary hypoplasia and possible neonatal demise. Fetal thoracoamiontic shunt (TAS) placement may decrease the amount of pleural effusion and improve lung expansion.
CASE
A 30-year-old primigravida at 29 2/7 weeks' gestation presented with fetal bilateral pleural effusions with no identifiable genetic or structural abnormalities. TAS placement accomplished decompression of the left fetal chest. The neonate was delivered at 33 3/7 weeks and required minimal respiratory support with no apparent long term complications at discharge.
CONCLUSION
This case demonstrated that fetal intervention with TAS placement can improve neonatal outcomes. Referral to an MFM specialist capable of TAS should be considered for isolated fetal bilateral pleural effusion.
背景
胎儿胸腔积液是一种罕见的胎儿异常，可能由先天性乳糜胸引起。严重的病例会导致胸腔压迫，从而导致肺发育不全和可能的新生儿死亡。胎儿胸导管分流术（TAS）的放置可能会减少胸腔积液量并改善肺扩张。
病例
一位 30 岁的初产妇，妊娠 29 周+7 天，胎儿双侧胸腔积液，无明确的遗传或结构异常。TAS 的放置完成了左胎儿胸部的减压。新生儿在 33 周+7 天分娩，仅需最低限度的呼吸支持，出院时无明显的长期并发症。
结论
该病例表明，TAS 放置的胎儿干预可以改善新生儿的结局。对于孤立性胎儿双侧胸腔积液，应考虑转介给能够进行 TAS 的胎儿医学专家。
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