Sherer David M, Kastrinakis Alyssa N, Sahawneh Farhan, Hsieh Vicky, Granderson Freeda, Kheyman Mila, Dalloul Mudar
The Divisions of Maternal Fetal Medicine, and Medical Genetics, The Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY.
Radiol Case Rep. 2025 Aug 16;20(11):5555-5561. doi: 10.1016/j.radcr.2025.07.040. eCollection 2025 Nov.
Fetal pleural effusion is considered a rare congenital anomaly with a reported incidence of between 1:10,000 and 1:15,000 deliveries. Fetal pleural effusion may be unilateral or bilateral, primary or secondary, congenital or acquired, isolated or a component of fetal hydrops. The clinical course of fetuses with pleural effusion is unpredictable with outcomes ranging between spontaneous resolution (in between 9 and 22% of cases), iatrogenic or spontaneous prematurity, and stillbirth. Fetal pleural effusion (fetal hydrothorax) can rapidly progress to severe fetal hydrops, a complication associated with a mortality rate of approximately 50%. We present an unusual case of isolated marked bilateral pleural effusions of undetermined etiology. During preparation for possible fetal thoracocentesis for drainage in the event of the onset of fetal hydrops, rapid complete spontaneous resolution occurred within 5 days. Continued expectant management was performed with weekly sonographic surveillance and twice weekly fetal testing, with subsequent normal neonatal outcome. This case describes rapid worsening of fetal pleural effusions with subsequent spontaneous resolution, and emphasizes continued expectant management with close fetal surveillance.
胎儿胸腔积液被认为是一种罕见的先天性异常，据报道其在分娩中的发生率为1:10000至1:15000。胎儿胸腔积液可为单侧或双侧、原发性或继发性、先天性或后天性、孤立性或胎儿水肿的一部分。胸腔积液胎儿的临床病程不可预测，结局包括自然消退（9%至22%的病例）、医源性或自然早产以及死产。胎儿胸腔积液（胎儿胸水）可迅速发展为严重的胎儿水肿，这是一种死亡率约为50%的并发症。我们报告一例病因不明的孤立性明显双侧胸腔积液的罕见病例。在为可能发生的胎儿水肿进行胎儿胸腔穿刺引流做准备期间，胸腔积液在5天内迅速完全自然消退。随后进行了持续的期待治疗，每周进行超声监测，每周两次进行胎儿检测，新生儿结局正常。本病例描述了胎儿胸腔积液迅速恶化随后自然消退的情况，并强调了通过密切的胎儿监测进行持续的期待治疗。
