Pleural effusions and pulmonary hypoplasia

A case of successful fetal therapy for congenital chylothorax by intrapleural injection of OK‐432

“…The outcome of severe NIHF detected in the early gestational stage has been assumed to be poor 2,3,16 . However, in cases with severe pleural effusion such as chylothorax, which causes pulmonary hypoplasia and circulatory failure induced by physical pressure, removal of the pleural effusion seems to be associated with a better prognosis 4,5,16 .…”

“…Congenital fetal chylothorax is one cause of non-immune hydrops fetalis (NIHF) 1,2 , and severe pleural effusion occurring in the second trimester causes pulmonary hypoplasia as a result of impairment of lung growth by compression 3 . Owing to advances in medical imaging techniques such as sonography, NIHF is often detected at an early gestational stage, and the usefulness of intrauterine treatment such as frequent thoracocentesis or shunt insertion for pleural effusion has been reported 4,5 .…”

Prenatal sonographic chest and lung measurements for predicting severe pulmonary hypoplasia

“…Predisposing factors include prolonged preterm rupture of the membranes, skeletal dysplasia, abnormalities of the fetal urinary system combined with severe oligohydramnios as well as diaphragmatic hernia and hydrothorax (Nimrod et al, 1988;Quinlan et al, 1986;Vintzileos et al, 1989;Castillo et al, 1987). In pregnancies with severe oligohydramnios secondary to preterm rupture of the membranes or urogenital malformations, pulmonary hypoplasia develops as a result of the reduction of intrapulmonary fluid.…”

The influence of pleural effusion on pulmonary growth in the human fetus

“…CASTILLO et al [2] reported that normal lung development was disturbed in 9 cases of NIHF with pleural effusion, using histological examination. In the present study, 12 of 20 cases had lung weights of less than -1.5 S. D. and 7 cases had lung weights of less than -2.0 S.D.…”

“…The earlier the gestational age at the onset of pleural effusion, the stronger the influence on pulmonary development may be. CASTILLO et al [2] suggested that significant fluid ; accumulation in the pleural space prior to the alveolar stage could cause inevitable damage to the developing lung in a fetus. NIMROD et al [6] reported that, in fetuses with premature rupture of membrane, the risk of developing pulmonary hypoplasia was significantly higher in fetuses with rupture of membranes before 26 weeks of gestation, compared to that of fetuses with a rupture of membrane after 26 weeks of gestation.…”