Noninvasive management of isolated bilateral fetal hydrothorax

Purpose: The incidence of fetal hydrothorax is estimated to be 1 in 15000 pregnancies. In the absence of hydrops fetal medicine specialists consider invasive prenatal treatment not indicated. The evidence is limited, as it consists exclusively of case-reports.

Material and methods: Case report, literature review.

Results: Pregnant refugee from Syria was referred because of pleural effusion @ 33 weeks.

Ultrasound scan revealed a female fetuses with isolated hydrothorax, polyhydramnios and the absence of hydrops (Fig. 1).

Fig. 1: bilateral fetal hydrothorax

Additional congenital, structural and chromosomal anomalies were ruled out. Besides this the patient was diagnosed with gestational diabetes. According to the NICE Guideline, 2006 no invasive prenatal treatment was carried out. Under close surveillance ultrasound spontaneous resolution of pleural effusion was observed within 2 weeks. (Fig. 2).

Fig. 2: spontaneous resolution of pleural effusion

Data from literature review is given comparing survival with and without pleuroamniotic shunting.

Conclusion: In this present case noninvasive management of isolated fetal hydrothorax seems to have been justified.