Universität zu Köln

Mallmann, Michael R., Graham, Viola, Roesing, Bettina, Gottschalk, Ingo, Mueller, Andreas, Gembruch, Ulrich ORCID: 0000-0001-8284-4669, Geipel, Annegret and Berg, Christoph (2017). Thoracoamniotic Shunting for Fetal Hydrothorax: Predictors of Intrauterine Course and Postnatal Outcome. Fetal Diagn. Ther., 41 (1). S. 58 - 66. BASEL: KARGER. ISSN 1421-9964

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Abstract

Objective: To assess predictors for survival and complications among a relatively large cohort of fetuses with hydro thorax treated by thoracoamniotic shunting. Methods: All cases with hydrothorax treated by thoracoamniotic shunting in a 10-year period (2002-2011) in two centers were retrospectively reviewed. Results: A total of 78 fetuses with hydrothorax treated with thoracoamniotic shunting were included in the study. Mean gestational age at diagnosis was 25.6 weeks (12-34 weeks). Initial thoracoamniotic shunting was performed at a mean gestational age of 26.5 weeks (16-33 weeks). A mean of 2.53 shunts (1-7) were inserted per fetus. Of the 78 fetuses, 9 (11.5%) died in utero, 69 (88.5%) were born alive and 46 (59%) survived. Prognostic markers significantly associated with nonsurvival were polyhydramnios, hydrops placentae and mediastinal shift at initial scan, onset of hydrops after first shunt placement, rupture of membranes, a shunt-birth interval <4 weeks and low gestational age at birth. In our cohort, fetuses with trisomy 21 had a significantly better survival than euploid fetuses. Conclusions: Although associated with a significant rate of repeated interventions, thoracoamniotic shunting in fetuses with severe hydrothorax results in an overall survival rate of 59%. Fetuses with hydrothorax and trisomy 21 have a better survival when compared to euploid fetuses. (C) 2016 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mallmann, Michael R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Graham, Viola UNSPECIFIED UNSPECIFIED UNSPECIFIED Roesing, Bettina UNSPECIFIED UNSPECIFIED UNSPECIFIED Gottschalk, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Gembruch, Ulrich UNSPECIFIED orcid.org/0000-0001-8284-4669 UNSPECIFIED Geipel, Annegret UNSPECIFIED UNSPECIFIED UNSPECIFIED Berg, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-243390
DOI:	10.1159/000446110
Journal or Publication Title:	Fetal Diagn. Ther.
Volume:	41
Number:	1
Page Range:	S. 58 - 66
Date:	2017
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9964
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PLEURAL EFFUSION; CHYLOTHORAX; PLEURODESIS; MANAGEMENT; INSERTION; THERAPY; OK-432 Multiple languages Obstetrics & Gynecology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24339