open access

Vol 85, No 9 (2014)
ARTICLES
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Successful treatment of fetal bilateral primary chylothorax – report of the two cases

Dorota Nowakowska, Zuzanna Gaj, Mariusz Grzesiak, Jan Wilczyński, Ewa Gulczyńska
DOI: 10.17772/gp/1797
·
Ginekol Pol 2014;85(9).

open access

Vol 85, No 9 (2014)
ARTICLES

Abstract

Primary fetal chylothorax is an uncommon complication, associated with high perinatal morbidity and mortality. In our report, we describe two cases of fetal bilateral primary chylothorax successfully treated with pleuro-amniotic In both cases, ultrasound scans showed bilateral, hypoechoic fluid in the pleural space without any associated structural malformations and features of infection and aneuploidy. Laboratory analysis of pleural fluids revealed 79% and 92% of lymphocytes, respectively, confirming chylothorax in both fetuses. In the first case, pleuro-amniotic shunts were successfully inserted at 31 weeks and 6 days of gestation. Ultrasound scan after two weeks showed expansion of the left lung and lack of fluid in both pleural cavities. At 39 weeks of gestation, a 2660 g baby boy was delivered by cesarean section (Apgar score: 9). The child did not require surgical intervention and was discharged home on day 16 of life. In the second case, the insertion of shunts (at 24 weeks and 6 days of gestation) also significantly reduced the amount of the fluid in the pleural cavities, but one shunt had to be surgically removed after birth. At 30 weeks and 2 days of gestation, a cesarean section was performed due to maternal cholestasis. A female weighing 1400 g was delivered (Apgar score: 7). The chest X-ray revealed only a small amount of fluid in the left pleural cavity. The infant was discharged on postnatal day 26, in good condition and with body weight of 2150g. Pleuro-amniotic shunt insertion is a method of choice in the treatment of confirmed primary fetal chylothorax.

Abstract

Primary fetal chylothorax is an uncommon complication, associated with high perinatal morbidity and mortality. In our report, we describe two cases of fetal bilateral primary chylothorax successfully treated with pleuro-amniotic In both cases, ultrasound scans showed bilateral, hypoechoic fluid in the pleural space without any associated structural malformations and features of infection and aneuploidy. Laboratory analysis of pleural fluids revealed 79% and 92% of lymphocytes, respectively, confirming chylothorax in both fetuses. In the first case, pleuro-amniotic shunts were successfully inserted at 31 weeks and 6 days of gestation. Ultrasound scan after two weeks showed expansion of the left lung and lack of fluid in both pleural cavities. At 39 weeks of gestation, a 2660 g baby boy was delivered by cesarean section (Apgar score: 9). The child did not require surgical intervention and was discharged home on day 16 of life. In the second case, the insertion of shunts (at 24 weeks and 6 days of gestation) also significantly reduced the amount of the fluid in the pleural cavities, but one shunt had to be surgically removed after birth. At 30 weeks and 2 days of gestation, a cesarean section was performed due to maternal cholestasis. A female weighing 1400 g was delivered (Apgar score: 7). The chest X-ray revealed only a small amount of fluid in the left pleural cavity. The infant was discharged on postnatal day 26, in good condition and with body weight of 2150g. Pleuro-amniotic shunt insertion is a method of choice in the treatment of confirmed primary fetal chylothorax.
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Keywords

primary fetal chylothorax, Pleural Effusion, pleuro-amniotic shunts, pregnancy

About this article
Title

Successful treatment of fetal bilateral primary chylothorax – report of the two cases

Journal

Ginekologia Polska

Issue

Vol 85, No 9 (2014)

DOI

10.17772/gp/1797

Bibliographic record

Ginekol Pol 2014;85(9).

Keywords

primary fetal chylothorax
Pleural Effusion
pleuro-amniotic shunts
pregnancy

Authors

Dorota Nowakowska
Zuzanna Gaj
Mariusz Grzesiak
Jan Wilczyński
Ewa Gulczyńska

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