Pleural effusion is a general term for the accumulation of fluid in the pleural space. Incidence is approximately 1/15000 pregnancies. It is frequently associated with extra thoracic anomalies, abnormal karyotype and congenital heart disease. The mortality rate is 53 % but in cases with associated hydrops may be as high as 95%. Spontaneous resolution or regression has been reported in 9 to 22 % and has been associated with nearly 100 % of survival. Intrauterine interventions such as thoracocentesis and pleuroamniotic shunting are considered to avoid progression of an otherwise potentially fatal disease. The presence of hydrothorax does not influence the mode of delivery and cesarean section should be reserved for obstetrical indications. We present a case of 36-year-old woman (G2, P1) referred to University obstetrics and gynecology clinic due to bilateral fetal pleural effusion in 28 gestational weeks. Standard ultrasound biometric parameters were adequate, Doppler of the fetomaternal unit, TORCH and amniocentesis for fetal karyotype were normal. Serial ultrasounds follow up was performed and there was a total reduction of the pleural fluid in 34gw. She was delivered in 38gw by cesarean section due to polyhydramnios, pedalic fetal lie and macrosomia. Neonatal outcome was uneventful and there were no signs of neonatal respiratory distress. Fetal pleural effusion is a rare but potentially fatal condition. Spontaneous resolution is possible and most desirable occasion.
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