Grandt Joleen, Gottschalk Ingo, Geipel Annegret, Gembruch Ulrich, Simonini Corinna, Weber Eva, Berg Christoph, Müller Andreas, Strizek Brigitte
Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany.
Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, University of Cologne, 50923 Cologne, Germany.
J Clin Med. 2022 Apr 21;11(9):2312. doi: 10.3390/jcm11092312.
(1) Background: Severe fetal hydrothorax can be treated by intrauterine thoracoamniotic shunting (TAS). The aim of this study was to assess perinatal outcome and complication rates of TAS with a novel Somatex intrauterine shunt. (2) Methods: This is a single-center retrospective study of all fetuses with hydrothorax treated with TAS using a Somatex shunt between 2014 and 2020. (3) Results: A total of 39 fetuses were included in the study. Mean gestational age at first intervention was 27.4 weeks (range 19-33). Of these, 51% ( = 20) of fetuses had fetal hydrops, which resolved in 65% (13/20) before delivery. The live birth rate was 97% ( = 38), and 74% ( = 29) survived the neonatal period. The rate of postnatal pulmonary complications was high, with 88% of neonates requiring any kind of ventilatory support. There were 23% ( = 9) genetic abnormalities (trisomy 21 and Noonan syndrome). (4) Conclusions: TAS with a Somatex shunt has a high technical success rate, leading to high neonatal survival rates. Pregnancy and neonatal outcome is comparable to TAS for fetal hydrothorax using different shunt types.
（1）背景：严重胎儿胸腔积液可通过宫内胸腔羊膜分流术（TAS）治疗。本研究的目的是评估使用新型索马特克斯宫内分流器进行TAS的围产期结局和并发症发生率。（2）方法：这是一项单中心回顾性研究，纳入了2014年至2020年间所有使用索马特克斯分流器进行TAS治疗的胸腔积液胎儿。（3）结果：本研究共纳入39例胎儿。首次干预时的平均孕周为27.4周（范围19 - 33周）。其中，51%（n = 20）的胎儿有胎儿水肿，65%（13/20）在分娩前水肿消退。活产率为97%（n = 38），74%（n = 29）存活至新生儿期。产后肺部并发症发生率较高，88%的新生儿需要任何类型的通气支持。有23%（n = 9）的胎儿存在基因异常（21三体综合征和努南综合征）。（4）结论：使用索马特克斯分流器进行TAS技术成功率高，新生儿存活率也高。对于胎儿胸腔积液，使用不同分流器类型进行TAS的妊娠和新生儿结局相当。
