Abstract
Objective Nonimmune hydrops fetalis (NIHF) is defined as the accumulation of excess fluid in
two or more body cavities in the fetus without blood incompatibility between mother
and baby. We aimed to present our prenatal and postnatal management of intrauterine
pleural effusions associated with NIHF.
Study Design A total of 60 patients diagnosed with NIHF with intrauterine pleural effusion were
analyzed retrospectively. Gestational age of delivery or fetal demise, the intrauterine
treatment procedure including extrauterine intrapartum treatment (EXIT), chest tube,
and medical treatment methods in fetuses with chylothorax analyzed.
Results Thirty-nine patients (65%) were born alive between 26 and 38 weeks. A thoracoamniotic
shunt was placed in one patient during the intrauterine period. Seven patients were
placed bilaterally during the postnatal period, all without the umbilical cord being
clamped during delivery. But 25 patients died within the first few days following
birth. A total of four patients had chylothorax. Two patients who did not respond
to medical treatment (somatostatin) were injected with thoracic local batticon and
cured. A total of 14 patients were discharged with healing.
Conclusion Cases of progressive prenatal pleural effusions associated with NIHF have a high
risk for fetal and neonatal death. We think that extreme prematurity increases postnatal
mortality because it negatively affects the development of the lung and heart. A close
obstetric follow-up and a multidisciplinary approach are required for the management
to be selected.
Keywords
nonimmune hydrops fetalis - intrauterine pleural effusions - batticon - EXIT procedure
