Are pregnancies with severe fetal hydrothorax and very short cervix candidates for pleuroamniotic shunting?

Abstract

Fetal hydrothorax is a congenital anomaly primary due to leakage of lymphatic fluid into the pleural space. Cases with massive pleural effusions associated with hydrops are at a higher risk of perinatal death. For those at-risk cases, pleuroamniotic shunt (PAS) placement has demonstrated to be an effective fetal therapy to improve survival. However, such intervention is associated with risks of preterm rupture of membranes (PPROM) and preterm birth, which leads to a detrimental effect on neonatal survival1, 2 . In a recent study, preoperative cervical length (CL) was positively correlated with the interval time between PAS and delivery3 . Pregnancies with short cervix (<25mm) were associated with a significantly higher risk of delivery within the first week after PAS but similar neonatal survival rates were observed between the group with and without short cervix. Due to the expected higher risk of preterm delivery, previous studies have excluded for PAS those pregnancies with very short cervix4, 5 . However, whether the group with very short cervix are benefit of PAS remains unknown and thus, we aimed to compare the survival rate of cases with severe hydrothorax with and without preoperative CL<15mm. This article is protected by copyright. All rights reserved.