2003-01-14-15 Chylothorax drainage © Sosa www.thefetus.net/
Chylothorax drainage
Alberto Sosa. MD, PhD, Luis Diaz Guerrero, MD, Giugni Chalbaud, MD
Perinatology Unit, Carabobo University, Valencia – Venezuela
This is a 31-year-old primigest with an unremarkable pregnancy. At 15 weeks she has an amniocentesis for an elevated screening test for trisomy 21. A normal male karyotype is obtained.
At 27 weeks a left hydrothorax is visible but since there is no mediastinal shift we elected to observe her weekly. At 28 weeks the hydrothorax has increased and resulted in a mediastinal shift with dextrocardia. We performed a thoracocentesis, drained 50 cc of fluid and attempted a pleurodesis with intrapleural triamcinolone.
The analysis of the pleural fluid revealed 100% lymphocytes.
The pleural effusion recurred at 29 weeks, at which time a repeat tap with drainage of another 40cc was performed.


At 30 weeks we decided to place a thoraco-amniotic shunt (double pigtail Harrison shunt). Shunt placement and function were satisfactory. Doppler indices of pulmonary resistance progressively decreased.
November 11:


November 27:


November 30:

December 16:

January 4:

At 39 weeks the shunt migrated into the thorax, and an elective cesarean section was performed. The Apgars were 9 & 10.


The postnatal evolution of the baby was unremarkable. The X-ray confirmed the intrathoracic location of the shunt.
