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. 2022 Apr 21;11(9):2312.
doi: 10.3390/jcm11092312.

Intrauterine Thoracoamniotic Shunting of Fetal Hydrothorax with the Somatex Intrauterine Shunt: Intrauterine Course and Postnatal Outcome

Joleen Grandt  1 , Ingo Gottschalk  2 , Annegret Geipel  1 , Ulrich Gembruch  1 , Corinna Simonini  1 , Eva Weber  2 , Christoph Berg  1   2 , Andreas Müller  3 , Brigitte Strizek  1
Affiliations

Intrauterine Thoracoamniotic Shunting of Fetal Hydrothorax with the Somatex Intrauterine Shunt: Intrauterine Course and Postnatal Outcome

Joleen Grandt et al. J Clin Med. .

Abstract

(1) Background: Severe fetal hydrothorax can be treated by intrauterine thoracoamniotic shunting (TAS). The aim of this study was to assess perinatal outcome and complication rates of TAS with a novel Somatex intrauterine shunt. (2) Methods: This is a single-center retrospective study of all fetuses with hydrothorax treated with TAS using a Somatex shunt between 2014 and 2020. (3) Results: A total of 39 fetuses were included in the study. Mean gestational age at first intervention was 27.4 weeks (range 19-33). Of these, 51% (n = 20) of fetuses had fetal hydrops, which resolved in 65% (13/20) before delivery. The live birth rate was 97% (n = 38), and 74% (n = 29) survived the neonatal period. The rate of postnatal pulmonary complications was high, with 88% of neonates requiring any kind of ventilatory support. There were 23% (n = 9) genetic abnormalities (trisomy 21 and Noonan syndrome). (4) Conclusions: TAS with a Somatex shunt has a high technical success rate, leading to high neonatal survival rates. Pregnancy and neonatal outcome is comparable to TAS for fetal hydrothorax using different shunt types.

Keywords: fetal hydrops; fetal hydrothorax; fetal pleural effusion; fetal therapy; thoracoamniotic shunting.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Shunt types used for thoracoamniotic shunting.
Figure 2
Figure 2
(a) Correct position of a Somatex shunt (axial view). Outward flow through the shunt is demonstrated by color Doppler. (b) Intracutaneous dislocation of a Somatex shunt in a fetus with massive skin edema on an axial view of the thorax. The inner end of the shunt is not reaching the pleural cavity.
See this image and copyright information in PMC

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