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产前胸腔穿刺术:先天性乳糜胸病例报告

Antepartum Thoracocentesis: A Case Report on Congenital Chylothorax.

作者信息

Almeida Maria, Campos Marta, Soares Celia, Godinho Cristina, Brito Maria

机构信息

Obstetrics and Gynecology, Unidade Local de Saúde de Trás-os-Montes e Alto, Vila Real, PRT.

Obstetrics and Gynecology, Unidade Local de Saúde de Gaia e Espinho, Vila Nova de Gaia, PRT.

出版信息

Cureus. 2025 Aug 17;17(8):e90275. doi: 10.7759/cureus.90275. eCollection 2025 Aug.

Abstract

Congenital chylothorax remains a poorly understood condition, and the optimal approach to its management continues to evolve. Rapid progression of pleural effusion with mediastinal shift and/or development of hydrops fetalis are key indications for urgent fetal intervention to enable thoracic decompression and prevent fetal compromise. We report a case of isolated mild unilateral pleural effusion identified during routine midtrimester ultrasound, successfully managed through close ultrasonographic surveillance and perinatal thoracocentesis performed immediately before delivery to facilitate lung expansion and minimize cardiopulmonary compromise. Prenatal intervention in this context was associated with favorable neonatal outcomes, including improved Apgar scores, reduced ventilator dependence, and fewer complications.

摘要

先天性乳糜胸仍然是一种了解甚少的病症,其最佳治疗方法也在不断发展。胸腔积液迅速进展伴有纵隔移位和/或胎儿水肿的发生是进行紧急胎儿干预以实现胸腔减压并防止胎儿受损的关键指征。我们报告了一例在孕中期常规超声检查时发现的孤立性轻度单侧胸腔积液病例,通过密切超声监测和在分娩前立即进行围产期胸腔穿刺术成功进行了治疗,以促进肺扩张并最大程度减少心肺功能损害。在这种情况下的产前干预与良好的新生儿结局相关,包括阿氏评分提高、呼吸机依赖减少和并发症减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3a7/12439228/99444c53e9f2/cureus-0017-00000090275-i01.jpg

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