Fetal pleural effusion

Fetal pleural effusions (FPE) refer to an accumulation of pleural fluid in utero. It can refer to either a fetal chylothorax or a fetal hydrothorax.

A fetal pleural effusion can occur as part of hydrops fetalis, in association with other anomalies without hydrops or in isolation - primary pleural effusion/primary fetal hydrothorax (PFHT).   

Causes

Any cause of hydrops fetalis is a potential aetiological factor in a fetal pleural effusion.

Associations

In addition to hydrops fetalis, a pleural effusion can be associated with numerous other underlying anomalies:

Antenatal ultrasound

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)

The clinical course is variable and dependent on aetiology. The presence of a pleural effusion early in pregnancy (i.e first trimester) is often associated with a poor fetal outcome 5.

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 

 

Share Article

Article Information

rID: 13474
System: Obstetrics
Section: Gamuts
Synonyms or Alternate Spellings:
  • Pleural effusion in utero
  • Fetal pleural effusion (FPE)

Support Radiopaedia and see fewer ads

  • Drag
    Case 1: occurring with hydrops fetalis
    Drag here to reorder.
  • Drag
    Case 2: with hydrops fetalis
    Drag here to reorder.
  • Drag
    Case 3: with hydrops fetalis
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.