fetal pleural effusion
Any cause of hydrops fetalis is a potential etiological factor in a fetal pleural effusion.
In addition to hydrops fetalis, a pleural effusion can be associated with numerous other underlying anomalies:
- congenital cardiac anomalies: ~ 5% of non hydropic pleural effusions
- underlying congenital lung anomalies
- chromosomal anomalies (can be present in ~ 50% with an additional sonographic abnormality and ~ 12% without an additional sonographic abnormality )
- polydactyly: ~ 1% of non hydropic pleural effusions
Classically seen as anechoic fluid surrounding one or both the lungs (which are echogenic) - batwing appearance.
Ancillary sonographic features include:
- may show other features of hydrops if it occurs in association
- there maybe presence of polyhydramnios (if severe)
Treatment and prognosis
The clinical course is variable and dependent on etiology. The presence of a pleural effusion early in pregnancy (i.e. first trimester) is often associated with a poor fetal outcome .
Management options are also dependent on other underlying factors:
- thoracocentesis and drainage of the effusion: fluid can however reaccumulate within 24-48 hours
- insertion of pleural-amniotic shunts