Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Kowloon, Hong Kong, China.
Fetal Diagn Ther. 2021;48(6):440-447. doi: 10.1159/000515849. Epub 2021 Jun 2.
Fetal pleural effusion may require in utero shunting which is associated with procedure-related complications.
To evaluate the efficacy and complications of the newly designed Somatex shunt in treating fetal pleural effusion.
Consecutive cases with primary fetal pleural effusion who were treated with the Somatex shunt between 2018 and 2019 were evaluated. Perinatal outcomes and complications were retrospectively analyzed.
There were 6 cases of unilateral and 1 case of bilateral pleural effusion, and hence a total of 8 pleuroamniotic shunting procedures were performed. The median gestational age at diagnosis and shunting was 20.7 and 22.6 weeks, respectively. All 8 procedures were successful, achieving complete in utero drainage. All but one were live births (85.7%) with a median gestational age of 38 weeks. The single case of in utero death occurred 4.7 weeks after successful shunting, and no cause could be identified after autopsy. The rates of preterm birth and premature rupture of membranes were 33.3% (2/6) and 16.7% (1/6), respectively. Four of the 8 procedures (50%) had minor shunt-related complications such as dislodgement and entrapment, occurring at a median of 7.7 weeks after shunting. None of the shunts became blocked.
The Somatex shunt is effective in relieving fetal pleural effusions with good survival rate. Overall, it was a safe instrument, though minor shunt complications occurred.
胎儿胸腔积液可能需要宫内分流，这与手术相关并发症有关。
评估新型 Somatex 分流器治疗胎儿胸腔积液的疗效和并发症。
回顾性分析 2018 年至 2019 年间接受 Somatex 分流器治疗的原发性胎儿胸腔积液连续病例。分析围产儿结局和并发症。
单侧胸腔积液 6 例，双侧胸腔积液 1 例，共进行 8 例胸腔羊膜分流术。诊断和分流的中位孕龄分别为 20.7 周和 22.6 周。8 例手术均成功，完全实现了宫内引流。除 1 例外均为活产（85.7%），中位孕龄为 38 周。1 例在成功分流后 4.7 周宫内死亡，但尸检后无法确定原因。早产和胎膜早破的发生率分别为 33.3%（2/6）和 16.7%（1/6）。8 例中有 4 例（50%）发生轻微分流相关并发症，如移位和嵌顿，发生在分流后中位时间为 7.7 周。没有分流器堵塞。
Somatex 分流器治疗胎儿胸腔积液有效，存活率高。总体而言，它是一种安全的器械，尽管发生了轻微的分流并发症。
