Chao A S, Chung C L, Cheng P J, Lien R, Soong Y K
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
J Formos Med Assoc. 1998 Sep;97(9):646-8.
Isolated bilateral pleural effusion with mediastinal compression leading to hydropic change of the fetus is unusual, and carries a high risk of perinatal death. This condition can be reversed in utero by performing ultrasound-guided shunting surgery. We describe a hydropic fetus at 30 weeks' gestation with rapid recurrence of pleural effusion after thoracentesis. The pleural effusion and hydrops resolved within 1 week after ultrasound-guided thoracoamniotic shunt and the fetal lungs were restored to their normal size. The fetus was born at 35 weeks' gestation and had an uneventful postnatal course. The technique of restoring cardiopulmonary function in utero through intrathoracic decompression offers a valuable alternative to repetitive prenatal thoracentesis or preterm delivery of fetuses with hydrops caused by bilateral pleural effusion.
孤立性双侧胸腔积液伴纵隔受压导致胎儿水肿改变较为罕见，且围产期死亡风险很高。通过超声引导下分流手术可在子宫内逆转这种情况。我们描述了一名妊娠30周的水肿胎儿，胸腔穿刺术后胸腔积液迅速复发。超声引导下胸腔羊膜分流术后1周内胸腔积液和水肿消退，胎儿肺恢复正常大小。胎儿在妊娠35周时出生，出生后过程顺利。通过胸腔内减压在子宫内恢复心肺功能的技术为反复进行产前胸腔穿刺或因双侧胸腔积液导致水肿的胎儿早产提供了一种有价值的替代方法。
