Antenatal diagnosis of congenital chylothorax by gray scale sonography

Abstract

In a patient with hydramnios, fetal hydrops was diagnosed by B mode ultrasound. Gray scale sonography visualized fluid in the fetal pleural cavity. The diagnosis (congenital chylothorax) was confirmed at autopsy.

Fetal Hydrothorax in the Second Trimester of Pregnancy: Successful Intra-Uterine Treatment at 24 Weeks Gestation

“…A change occurring after the 16th week will affect the size, not the number, of these airways and also affect the developing acinus or gas-exchanging portion of the tra cheobronchial tree which includes the respi ratory bronchioles, alveolar ducts, sacs and alveoli [23]. Normal lung growth also de pends on the presence of fetal breathing movements which may be impaired by excess fluid affecting diaphragmatic movement [3,23]. Experimentally, relief of lung compres sion which would result in fatal pulmonary hypoplasia can allow sufficient pulmonary growth and development to support life at birth [24].…”

Mid‐Trimester fetal thoracentesis

“…l5 Defoort and Thiery, however, report a case of congenital fetal pleural effusion in which intrauterine fetal demise occurred, most likely because of increased intrathoracic pressure causing congestive heart failure and hydrops. 16 Because the unilateral pleural effusion in our case created a severe shift of the mediastinum and appeared to invert the dome of the diaphragm, we suggest that the multiple thoracenteses performed on this fetus between 19 and 22.5 weeks may have contributed to the normal lung development and a successful outcome of this pregnancy. However, until such time as the natural history of this disease is fully understood, active intervention for fetal pleural effusions in the antepartum period may not be justified for every fetus and each case should be evaluated individually.…”

Ultrasonic real‐time diagnosis of fetal hydrothorax and lung hypoplasia

“…8 Our diagnostic evaluation was made easier by the presence of the hydrothorax, which enabled us to clearly observe the thoracic structures and hypoplastic lungs.…”