Thoracoamniotic Shunt Procedure: Review of 10 cases at a Tertiary Setting

Öz

Aim: To review the perinatal outcome in fetal thoracoamniotic shunt procedures.Material and Methods: Thoracoamniotic shunt-treated cases were screened retrospectively between 2008-2013. The current status of the parents of the newborn was learned by phone interview.Results: The study included 10 patients in whom thoracoamniotic shunt was inserted. Fetal diseases requiring thoracoamniotic shunt procedure were primary pleural effusion in 9 90% cases and type 1 congenital cystic adenomatoid malformation CCAM in 1 10 % case. In 2 cases 20% the procedure was repeated due to dislodgement of the shunt. Fetal loss was observed in 1 case after the procedure. 3 fetuses died in the neonatal period and infancy. There were four cases of preterm delivery and 2 cases of fetal hydrops during follow-up. It was learned that neonate with CCAM had been operated at 1st week postpartum and there is currently no additional problem. No complications occurred in the remaining cases in the newborn period.Conclusion: Thoracoamniotic shunt procedure might have a positive influence on perinatal outcomes in fetuses with hydrothorax. Therefore, the family should be offered this procedure as an intrauterine fetal treatment option in fetuses with hydrothorax.

Anahtar Kelimeler

• Fetal hydrothorax,thoracoamniotic shunt,perinatal outcome

Torakoamniyotik Şant Uygulaması: Tersiyer Bir Merkezde 10 Vakanın Gözden Geçirilmesi

Öz

Amaç: Torakoamniyotik şant uygulanan vakaların gözden geçirilmesi ve perinatal sonuçlarının değerlendirilmesi.Gereç ve Yöntemler: 2008-2013 yıllarında torakoamniyotik şant işlem uygulanan vakalar retrospektif olarak tarandı. Yeni doğanların güncel durumları ise ailelerden sözel olarak öğrenildi.Bulgular: Çalışmaya torakoamniyotik şant uygulanan 10 vaka dahil edildi. İşlem öncesi 9 %90 vakaya primer plevral efüzyon, 1 %10 vakaya ise tip 1 konjenital kistik adenomatoid malformasyon ön tanısı kondu. 2 vakada %20 şantın yerinden çıkması nedeni ile tekrar torakoamniyotik şant uygulaması yapıldı. İşlem sonrası fetal kayıp 1 vakada izlendi. Neonatal ve infant dönemde 3 vaka kaybedildi. İşlem sonrası takipte 4 vakada preterm eylem ve doğum, 2 vakada ise fetal hidrops gelişti. Konjenital kistik adenomatoid malformasyon saptanan olgunun postpartum 1. haftada opere edildiği ve şu anda ek sorunu olmadığı öğrenildi. Diğer olgularda yeni doğanlar döneminde ve sonraki izlemlerinde ek komplikasyon saptanmadı.Sonuç: Fetal hidrotoraks varlığında torakoamniyotik şant uygulamasının perinatal sonuçlar üzerine olumlu etkisi olmaktadır. Bu nedenle aileye intrauterin fetal tedavi seçeneği olarak sunulmalıdır.

Anahtar Kelimeler

• Fetal hidrotoraks,torakoamniyotik şant,perinatal sonuç

Kaynakça

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