Mid-trimester thoracoamniotic shunting for the treatment of fetal primary pleural effusions in a twin pregnancy - A case report

Thoracoamniotic shunting has been described as having a beneficial role in the antenatal management of primary pleural effusions in singleton pregnanc ies. We report a case of a twin pregnancy in which progressive pleural effu sions and hydrops were diagnosed in one of the fetuses at 16 weeks of gesta tion. An initial evaluation ruled out underlying genetic and anatomic abnor malities in both twins. At 19 weeks gestation, the first procedure of bilat eral thoracoamniotic shunting was performed in the affected fetus, subseque nt to which the lungs re-expanded and the hydrops resolved. Three additiona l shunt replacements and one therapeutic amniocentesis were required on fol low-up. At 35 weeks, labor was induced. The first fetus (healthy) was deliv ered vaginally and the second fetus (affected) was delivered by cesarean se ction. Both neonates are healthy at one year follow-up. Copyright (C) 2000 S. Karger AG. Basel.