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.
The estimated prevalence is at ~ 1:10,000-15,000 pregnancies. There may be a greater male predilection.
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
- lymphovascular malformations 6
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.
Recognised complications include
Treatment and prognosis
The clinical course can be extremely variable. In selected cases a pleuro-amniotic shunt can be considered 6.
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- 2. Bianchi S, Lista G, Castoldi F et-al. Congenital primary hydrothorax: effect of thoracoamniotic shunting on neonatal clinical outcome. J. Matern. Fetal. Neonatal. Med. 2010;23 (10): 1225-9. doi:10.3109/14767051003678028 - Pubmed citation
- 3. Aubard Y, Derouineau I, Aubard V et-al. Primary fetal hydrothorax: A literature review and proposed antenatal clinical strategy. Fetal. Diagn. Ther. 13 (6): 325-33. Fetal. Diagn. Ther. (link) - Pubmed citation
- 4. Entezami M, Albig M, Knoll U et-al. Ultrasound Diagnosis of Fetal Anomalies. Thieme. (2003) ISBN:1588902129. Read it at Google Books - Find it at Amazon
- 5. Kumar P, Burton BK. Congenital malformations, evidence-based evaluation and management. McGraw-Hill Professional. (2007) ISBN:0071471898. Read it at Google Books - Find it at Amazon
- 6. Entezami M, Albig M, Knoll U et-al. Ultrasound Diagnosis of Fetal Anomalies. Thieme. (2003) ISBN:1588902129. Read it at Google Books - Find it at Amazon