Second Trimester Detection of Unilateral Hydrothorax: A Case Report of Successful Pregnancy Outcome with Passive Management

Abstract

EDITORIAL COMMENT: This case illustrates the important option of conservative management of abnormalities detected using ultrasound antenatally. The number of investigative and therapeutic techniques available for use on the fetus antenatally is increasing rapidly. All of these techniques however carry some degree of risk to the fetus. In some instances such as amniocentesis this risk is well defined but in others less well so. After the initial enthusiasm for operative intervention antenatally for treatment of such conditions as hydrocephalus and hydronephrosis most experts now recognize such procedures have a very limited role to play in the antenatal period. The natural history of many ultrasound detected abnormalities is poorly characterized. It is increasingly evident as more publications appear in the literature that many conditions such as that illustrated in this report will disappear spontaneously without any intervention being necessary.There is still a place for masterly inactivity in obstetrics. With the sophistication of modern technology, observation of fetal condition can indeed be masterly, but the need for clinical judgement is probably greater now that spectacular beneficial intervention is technically possible in some conditions.Our librarian traced for us the likely origin of the aphorism that ‘in obstetric practice an error of omission is better than an error of commission’—‘In medicine the sin of commission is mortal, the sin of omission venial.“1. Bulletin of the New York Academy of Medicine, 1929: 5.