Primary fetal hydrothorax

Last revised by David Luong on 28 Jul 2021

Primary fetal hydrothorax (PFHT) is a rare entity that 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 characterized by a collection of chyle within the pleural cavity.

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. 

Recognized complications include:

The clinical course can be extremely variable. In selected cases a pleuro-amniotic shunt can be considered 6.

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