In-utero treatment of prenatal thoracic abnormalities by thoraco-amniotic shunts, short and long term neuro developmental outcome: A single center experience
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In brief
In brief
Retrospective study of 38 fetuses treated with thoraco-amniotic shunts for fetal lung lesions or primary hydrothorax shows high perinatal survival (87.9%) and comparable neurodevelopmental outcomes between groups. Long-term follow-up demonstrates similar rates of developmental abnormalities and adaptive behavior scores regardless of indication.
Written by the GCMD Library team from the article.
Background
- Severe primary fetal hydrothorax (PFH) and fetal lung lesions (FLL) such as congenital pulmonary airway malformation (CPAM) and Bronchopulmonary sequestration (BPS) are often treated by thoraco-amniotic shunt (TAS).
Objectives
- To compare short and long-term outcome of fetuses treated by TAS due to FLL to those treated due to PFH.
Method
- A retrospective analysis was performed for all fetuses treated by TAS, between the years 2004-2015, evaluating the short and long term neurodevelopmental outcome. Long term neurodevelopment was additionally analyzed prospectively by Vineland adaptive behavioral scale (VABS) standardized questionnaires.
Results
- 38 fetuses were treated by 52 TAS insertions; of which 13 (35%) due to FLL and 25 due to PFH. Perinatal survival was high (87.9%) with 3 neonatal death and one termination of pregnancy (TOP). High survival rate persisted even in cases requiring recurrent shunt insertion (80% survival). There was no significant difference in short or long term outcome including perinatal survival (84% Vs 90%, P=0.64) and hydrops resolution (91% Vs 63%, p=0.19). Long term outcome, including rate of neurodevelopmental abnormalities (23.5% Vs 20%) and VABS score (91.3±13.3 Vs 96.4±14.7), were similar for both groups.
Conclusion
-TAS insertion is effective and resulting in high perinatal survival even in cases when sequential insertion is needed. Short and long- term outcome of neonates with FLL treated by TAS are comparable to neonates treated due to PFH.