Thoracoamniotic Shunts: Fetal Treatment of Pleural Effusions and Congenital Cystic Adenomatoid Malformations

@article{Wilson2004ThoracoamnioticSF,
  title={Thoracoamniotic Shunts: Fetal Treatment of Pleural Effusions and Congenital Cystic Adenomatoid Malformations},
  author={R. Douglas Wilson and Jason K. Baxter and Mark Paul Johnson and M. E. King and Stefanie B. Kasperski and Timothy M. Crombleholme and Alan W. Flake and Holly L. Hedrick and L.J. Howell and N.S. Adzick},
  journal={Fetal Diagnosis and Therapy},
  year={2004},
  volume={19},
  pages={413 - 420}
}
Objective: To determine whether fetuses that underwent thoracoamniotic shunt placement for treatment of pleural effusion (PE) or macrocystic congenital cystic adenomatoid malformation (CCAM) have an improved outcome as compared with an untreated population. Methods: A retrospective review from a single tertiary center was performed using thoracoamniotic shunt placement to treat PE or macrocystic CCAM between 1998 and 2001. Thoracoamniotic shunts were used on 26 occasions in 19 pregnancies… 
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Postnatal Chest Wall Deformities after Fetal Thoracoamniotic Shunting for Congenital Cystic Adenomatoid Malformation
TLDR
TA shunting at less than 21 weeks of gestational age may result in postnatal chest wall deformity, and this observation should be discussed during counseling for this procedure.
Thoracoamniotic shunting for fetal pleural effusion with hydropic change using a double-basket catheter: An insight into the preoperative determinants of shunting efficacy.
Congenital Cystic Adenomatoid Malformation and Intrauterine Cystoamniotic Shunt
TLDR
A 31-year-old woman carrying 22-weeks gestation fetus that has a large left-sided CCAM, severe mediastinal shift, and polyhydramnios admitted to the authors' clinic and delivered a female neonate, weighed 3150 gr by cesarean section, were uneventful.
Congenital pulmonary lymphangiectasis resulting in pleural effusions managed by thoracoamniotic shunting
Hemodynamic evaluation of a prenatal thoracoamniotic shunt for fetal pleural effusion.
Retrospective Review of Thoracoamniotic Shunting Using a Double-Basket Catheter for Fetal Chylothorax
TLDR
Thoracoamniotic shunting should be considered for pleural effusion before development of fetal hydrops, or at least before the appearance of fetal ascites, and a double-basket catheter tends to be obstructive, but may be less invasive for fetuses.
Effect of Maternal Betamethasone Administration on Prenatal Congenital Cystic Adenomatoid Malformation Growth and Fetal Survival
TLDR
In the fetus with a CCAM, the presence of hydrops fetalis or a CVR >1.6 is indicative of poor fetal outcome without prenatal intervention, and its potential to improve survival in high-risk groups is encouraging and warrants further controlled evaluations.
Percutaneous in utero thoracoamniotic shunt creation for fetal thoracic abnormalities leading to nonimmune hydrops.
Thoraco-amniotic shunting for fetal pleural effusion--a case series.
TLDR
There is increasing evidence that in utero therapy with thoraco-amniotic shunting improves prognosis by allowing lung expansion thereby preventing hydrops and pulmonary hypoplasia.
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