Abstract

ELIAS, Diego et al. Manejo interdisciplinario de un quilotórax congénito complicado con hidropesía fetal. Arch. argent. pediatr. [online]. 2005, vol.103, n.2, pp.171-174. ISSN 0325-0075.

The natural course of congenital chylothorax associated with hydrops fetalis results in an extremely high perinatal mortality. The aim of this study is to describe a potential intrauterine therapy in the perinatal management of this severe fetal condition. The present report describes a 27-week pregnancy with hydrops fetalis due to congenital chylothorax diagnosed through the analysis of fetal pleural fluid. At 29 weeks of gestational age, a pleuroamniotic shunt under ultrasound guidance was placed, and regression of the hidrops and of the hydrothorax was registered. At 32 weeks, displacement of the shunt and recurrence of the hydrothorax was observed. A cesarean section with an intraoperative thoracocentesis was performed. A 2,160 grams female newborn was obtained, who was electively intubated in the delivery room. Bilateral pleural tubes were also placed at once. The newborn had lung hypoplasia and was treated with surfactant, mechanical assisted ventilation and parenteral nutrition. Thereafter, enteral nutrition with a special milk due to the chylothorax was implemented. The newborn showed a favorable outcome with a normal follow-up at one year of age. The interdisciplinary management of a severe fetal and neonatal condition after prenatal diagnosis, such as primary fetal hydrothorax associated with hydrops fetalis, would allow to optimize the perinatal outcome through appropriate prenatal, perinatal and neonatal therapeutic strategies.

Keywords : chylothorax; fetal hidrothorax; pleuroamniotic shunt; hydrops fetalis.

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