CONGENITAL CHYLOTHORAX WITH HYDROPS - POSTNATAL CARE AND OUTCOME FOLLOWING ANTENATAL DIAGNOSIS

We consecutively managed 25 cases of fetal chylothorax with hydrops (p leuroamniotic shunting in 20/25 cases). Three of the 16 liveborn infan ts died before day 5 from malformations (n = 1) or complications of an tenatal origin (n = 2). Eleven of the 13 survivors were treated in our unit. Four infants whose chylothorax had resolved before birth follow ing antenatal shunting were delivered at term, and had no respiratory disease. Seven infants, whose chylothorax persisted, were delivered pr ematurely and required intensive respiratory care (with mechanical ven tilation for a median duration of 34 days). The 11 infants were mainta ined on total parenteral nutrition for a median duration of 31 days. T hey were discharged home after complete clinical recovery at a median age of 64 days. Antenatal pleuroamniotic shunting may improve the prog nosis of congenital chylothorax with hydrops. Chylothorax persisting a t birth resolves progressively with medical management.