A case of successful fetal therapy for congenital chylothorax by intrapleural injection of OK-432

A 38-year-old multiparous woman was referred at 19 weeks' gestation because of hydrops fetalis. Ultrasonic examination revealed severe pleural effusio n, ascites and skin edema. Detailed examination of the amniotic fluid, feta l blood and intrathoracic fluid led to a diagnosis of congenital fetal chyl othorax. Repeated thoracocenteses were not effective in improving the hydro ps fetalis. We introduced fetal treatment for the pleural effusion by an in trapleural injection of OK-432 at 23, 24 and 25 weeks' gestation. The pleur al effusion was reduced by adhesion of the intrathoracic space and resulted in the delivery of a neonate who was healthy except for right renal dysfun ction. Pulmonary hypoplasia was successfully prevented by OK-432.