primary fetal hydrothorax (PFHT)

A primary fetal hydrothorax (PFHT) is a rare situation and refers to a primary accumulation of fetal pleural fluid without any underlying abnormality. It can present with a wide spectrum of severity and can be uni or bilateral.

Epidemiology

The estimated prevalence is at ~ 1:10,000-15,000 pregnancies. There may be a greater male predilection.

Pathology

It is often characerterised by a collection of chyle within the pleural cavity.

Location - distribution

There may be an increased incidence on the right side

Associations
  • lymphovascular malformations

Radiographic features

Antenatal ultrasound

It is often a diagnosis of exclusion.

Ultrasound may show a fetal pleural effusion without any other associated sonographic abnormality. In some cases with dominant hydrothorax to one side, the fetal heart may be displaced to the opposite side.

Complications

Recognized complications include

Treatment and prognosis

The clinical course can be extremely variable. In selected cases a pleuro-amniotic shunt can be considered .

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