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Ruben S G M Witlox, Frans J C M Klumper, Arjan B Te Pas, Erik W van Zwet, Dick Oepkes, Enrico Lopriore
AIM: To evaluate the short-term neonatal outcome after fetal thoracoamniotic shunt placement for isolated hydrothorax. METHODS: Retrospective evaluation of infants with isolated hydrothorax treated with thoracoamniotic shunt placement at our fetal therapy centre between 2001 and 2016. RESULTS: In total 48 fetuses were treated with a thoracoamniotic shunt. All fetuses had signs of hydrops at the time of intervention. Median (IQR) gestational age at shunting was 28...
August 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
Terry Cullen, Clare Tower, Kristin Tanney
No abstract text is available yet for this article.
June 23, 2017: BMJ Case Reports
Wan-Ju Wu, Jin-Chung Shih, Haruhiko Sago, Ming Chen
OBJECTIVE: We presented a fetus affected by macrocystic lung lesions with progressive hydropic changes during the second trimester, but experienced remarkable resolution of hydrops in the third trimester after a series of in utero interventions. CASE REPORT: A 19-year-old women, G1P0, presented with fetal multilocular thoracic mass and hydropic change at 23(+4) weeks of gestation. After non-directive genetic counseling, she opted for intrauterine cyst aspiration followed by intra-cystic OK-432 injection at 24 weeks of pregnancy, as well as sequential thoracoamniotic shunts at 26 weeks and 27(+3) weeks of pregnancy when we observed hydrops developed progressively...
June 2017: Taiwanese Journal of Obstetrics & Gynecology
Yasuo Yumoto, Seung Chik Jwa, Seiji Wada, Yuichiro Takahashi, Keisuke Ishii, Kiyoko Kato, Noriaki Usui, Haruhiko Sago
OBJECTIVES: To determine the characteristics, outcomes, and prognostic factors of fetal hydrothorax (FHT) with trisomy 21. METHODS: A nationwide survey was conducted on FHT fetuses with trisomy 21 delivered after 22 weeks' gestation between January 2007 and December 2011 at perinatal centers. RESULTS: The 91 cases of FHT with trisomy 21 included 28 (30.8%) diagnosed in utero and 63 (69.2%) diagnosed after birth. The natural remission rate was 6...
May 11, 2017: Prenatal Diagnosis
Michelle Han, Yalda Afshar, Andrew H Chon, Emily Scibetta, Rashmi Rao, Ramen H Chmait
INTRODUCTION: Pseudoamniotic band syndrome (PABS) occurs iatrogenically after fetal surgery or amniocentesis due to chorioamniotic membrane separation. Separation of the amnion from the chorion can expand to form fibrous amniotic bands that can envelope fetal limbs or the umbilical cord, with consequences ranging from limb constriction to fetal demise. CASE REPORT: We report a case of bilateral fetal pleural effusions at 27 weeks' gestation treated by bilateral thoracoamniotic shunts...
April 28, 2017: Fetal and Pediatric Pathology
Shi-Min Yuan
Fetal cardiac tumors are rare and usually benign. While echocardiography is a reliable technique for diagnosing fetal cardiac tumors, their definitive diagnosis relies on pathological examination. The strategies used to manage fetal cardiac tumors are challenging. A good clinical result is their complete regression during pregnancy or shortly after birth, as often occurs with cardiac rhabdomyomas. Moreover, the fetal prognosis depends on the nature of the tumors, namely, their location, size, number and associated complications...
March 27, 2017: Journal of Perinatal Medicine
Seiji Wada, Seung Chik Jwa, Yasuo Yumoto, Yuichiro Takahashi, Keisuke Ishii, Noriaki Usui, Haruhiko Sago
OBJECTIVES: This study aims to determine the prognostic factors and outcomes of primary fetal hydrothorax (FHT) and investigate the effects of fetal therapy. METHODS: A nationwide survey was conducted on fetuses with primary FHT delivered after 22 weeks of gestation between January 2007 and December 2011 at perinatal centers. RESULTS: Among the 287 cases of primary FHT, the survival rates for those with and without hydrops were 58.0% (113/195) and 97...
February 2017: Prenatal Diagnosis
F Suyama, K Ozawa, R Sugibayashi, S Wada, H Sago
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
A Makishi, K Kiyoshi, T Funakoshi
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
P Chaveeva, V Stratieva, H Shivachev, S Aktash, M Panova, A Shterev
ABSTRACT OBJECTIVE: To present a case of macrocystic type cystic adenomatoid malformation of the lung (CCAM) treated with thoraco-amniotic shunt and to review the published data to evaluate the efficiency of thoraco-amniotic shunts for drainage of (CCAM). MATERIALS AND METHODS: This wass case reported of a fetus with a large thoracic cyst, major mediastinal shift and polyhidramnion treated with thoraco-amniotic shunting. We identified 8 cases diagnosed with CCAM and only one case met the criteria for fetal surgery...
2016: Akusherstvo i Ginekologii︠a︡
Magdalena Litwińska, Ewelina Litwińska, Katarzyna Janiak, Anna Piaseczna-Piotrowska, Ewa Gulczyńska, Krzysztof Szaflik
OBJECTIVE: To evaluate the efficiency of thoracoamniotic shunts for drainage of macrocystic-type congenital cystic adenomatoid malformation (CCAM). SUBJECTS AND METHODS: This was a retrospective study of 12 fetuses with a large thoracic cyst treated with thoracoamniotic shunting between 2004 and 2014 in a tertiary fetal therapy center. Medline was searched to identify cases of CCAM treated with thoracoamniotic shunting. RESULTS: In all cases the thoracic cyst was associated with major mediastinal shift, the CCAM volume ratio (CVR) was >1...
2017: Fetal Diagnosis and Therapy
Brenda Hiu Yan Law, Ioana Bratu, Venu Jain, Marc-Antoine Landry
Antenatally, congenital pulmonary airway malformation (CPAM) causing fetal hydrops can be palliated with thoracoamniotic shunts, which may become displaced in utero. We report a case of an infant born at 34 weeks gestational age with an antenatally diagnosed macrocystic lung lesion, fetal hydrops and an internally displaced thoracoamniotic shunt. The infant suffered refractory pneumothoraces despite multiple chest drains, and stabilised only after surgical resection of the lesion. Intraoperatively, the shunt was noted to form a connection between a type I CPAM and the pleural space...
July 28, 2016: BMJ Case Reports
Michael R Mallmann, Viola Graham, Bettina Rösing, Ingo Gottschalk, Andreas Müller, Ulrich Gembruch, Annegret Geipel, Christoph Berg
OBJECTIVE: To assess predictors for survival and complications among a relatively large cohort of fetuses with hydrothorax treated by thoracoamniotic shunting. METHODS: All cases with hydrothorax treated by thoracoamniotic shunting in a 10-year period (2002-2011) in two centers were retrospectively reviewed. RESULTS: A total of 78 fetuses with hydrothorax treated with thoracoamniotic shunting were included in the study. Mean gestational age at diagnosis was 25...
2017: Fetal Diagnosis and Therapy
Ba-Da Jeong, Hye-Sung Won, Mi-Young Lee, Jae-Yoon Shim, Pil-Ryang Lee, Ahm Kim
OBJECTIVE: The aim is to evaluate perinatal outcomes of fetal pleural effusion after thoracoamniotic shunting. METHODS: This was a retrospective study of 68 singleton pregnancies with massive fetal pleural effusion that underwent thoracoamniotic shunting between 1999 and 2012 at Asan Medical Center, Seoul, Korea. Through a review of medical records, we investigated perinatal outcomes according to the presence of fetal hydrops and identified prognostic factors by stepwise multivariate logistic regression analysis...
December 2015: Prenatal Diagnosis
Anna W Kneitel, Audrey Norby, Ivana Vettraino, Marjorie C Treadwell
Noonan syndrome is a multisystem genetic disorder caused by genes encoding proteins involved in the RAS-MAPK pathway. Affected fetuses have variable presentations ranging from the absence of prenatal findings to increased nuchal fold, cystic hygromas, pleural effusions, cardiac malformations, or skin edema. We describe a male fetus who had features consistent with Noonan syndrome at the time of fetal anatomic survey, including hydrops and a possible cardiac defect. Subsequent scan revealed persistent bilateral pleural effusions (with predominance of lymphocytes)...
2015: Fetal and Pediatric Pathology
Katarzyna Gajewska-Knapik, Lawrence Impey
Congenital lung lesions are common sonographic findings in pregnancy, usually detected at the routine 20 weeks scan. The most common is cystic adenomatous malformation of the lung (CCAM). This usually causes few prenatal problems; however, fetal hydrops occurs in about 5%. Prenatal intervention for these is possible in many to allow survival to birth. Bronchoplumonary sequestration (BPS), with an aberrant "feeder" vessel arising from the aorta may co-exist but is detectable as a separate entity by visualization of this vessel...
August 2015: Seminars in Pediatric Surgery
Krzysztof Szaflik, Magdalena Litwińska, Przemysław Oszukowski, Anna Piaseczna-Piotrowska, Ewelina Litwińska, Waldemar Krzeszowski, Ewa Gulczyńska, Iwona Maroszyńkas, Katarzyna Janiak
OBJECTIVES: The aim of the study was to evaluate the efficiency of intrauterine treatment of large cysts in fetal lungs using thoracoamniotic shunts. MATERIAL AND METHODS: Our observational retrospective study was carried out on a series of 8 fetuses who under went thoracoamniotic shunting after sonographic statement of large macrocystic lesions in the lungs at the Department of Gynecology Fertility and Therapy of the Fetus, Polish Mother's Research Institute, between 2009-2014...
January 2015: Ginekologia Polska
Magdalena Litwińska, Katarzyna Janiak, Anna Piaseczna-Piotrowska, Iwona Maroszyńska, Krzysztof Szaflik
Congenital cystic adenomatoid malformation is a rare disorder of the respiratory system which occurs with an incidence of 1/25,000-35,000. Depending on the size of the cysts, CCAM is classified into microcystic and macrocystic. Very large lesions carry a significant risk of causing both, pulmonary hypoplasia due to compression of the lung tissue and fetal hydrops, probably due to impaired cardiac function as a result of mediastinal shift and compression of the vena cava. In this report, we present a case of a fetus with prenatally diagnosed large cyst of the left lung...
November 2014: Ginekologia Polska
William H Peranteau, N Scott Adzick, Matthew M Boelig, Alan W Flake, Holly L Hedrick, Lori J Howell, Julie S Moldenhauer, Nahla Khalek, Juan Martinez-Poyer, Mark P Johnson
PURPOSE: Hydrops and pulmonary hypoplasia are associated with significant morbidity and mortality in the setting of a congenital lung lesion or pleural effusion (PE). We reviewed our experience using in utero thoracoamniotic shunts (TA) to manage fetuses with these diagnoses. METHODS: A retrospective review of fetuses diagnosed with a congenital lung lesion or pleural effusion who underwent TA shunt placement from 1998-2013 was performed. RESULTS: Ninety-seven shunts were placed in 75 fetuses...
February 2015: Journal of Pediatric Surgery
Francesco Macchini, Valerio Gentilino, Anna Morandi, Ernesto Leva
Fetal hydrothorax is associated with significant mortality. However, the development of fetal thoracoamniotic shunting has reduced the mortality rate. Fetal thoracoamniotic shunting can be characterized by significant complications, such as intrathoracic dislodgement of the catheter. The ideal management of dislodged catheters postnatally is not known. We report two newborns with a prenatal diagnosis of fetal hydrothorax who underwent thoracoamniotic shunting complicated by intrathoracic dislodgement of the catheters requiring thoracoscopic removal of the shunts in the neonatal period...
November 2014: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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