RT Book, Section
A1 Bianchi, Diana W.
A1 Crombleholme, Timothy M.
A1 D'Alton, Mary E.
A1 Malone, Fergal D.
SR Print(0)
ID 1106397612
T1 Hydrothorax
T2 Fetology: Diagnosis and Management of the Fetal Patient, 2e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-144201-5
LK obgyn.mhmedical.com/content.aspx?aid=1106397612
RD 2024/10/14
AB Key  PointsMay  be  primary,  due  to  chylous  leak,  or  secondary,  in  which  effusions  are  part  of  generalized  fluid  retention.  Secondary  hydrothorax  is  more  common  in  the  fetus  than  the  neonate.Sonography  demonstrates  an  anechoic  space  peripherally  around  the  compressed  lungs.  If  effusion  is  large  there  may  be  mediastinal  shift.  Polyhydramnios  is  present  in  60%  to  70%  of  cases.  Extrathoracic  anomalies  are  frequently  present.Prior  to  32  weeks  of  gestation  fetal  treatment  options  include:  thoracentesis,  thoracoamniotic  shunting,  and  thoraco-maternal  cutaneous  drainage.  Thoracentesis  should  be  performed  to  determine  if  the  effusion  is  chylous  and  to  obtain  a  cell  count,  differential,  and  culture.Decompression  of  the  fetal  chest  immediately  prior  to  delivery  is  controversial.Delivery  should  occur  in  a  tertiary  care  center.Up  to  5%  of  cases  are  associated  with  a  chromosome  abnormality,  such  as  Down  and  Turner  syndromes.