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2005-02-16-14 Pleural effusion, unilateral © Dhaifalah

Pleural effusion, unilateral

Ishraq Dhaifalah, MD, PhD, Jiri Santavy, MD
Department of Medical Genetic and Fetal Medicine. University Hospital, Olomouc, Czech Republic

This is a 21-year-old primigravida, who was referred to our department at 16 weeks of gestation because of a varicella virus infection that she had at 12 weeks of pregnancy. A right-sided pleural effusion was noted causing shift of the mediastinum and heart. No other abnormalities were noted. An amniocentesis performed for chromosome analysis revealed a normal male karyotype (46, XY). Polymerize Chain Reaction (PCR) studies were negative for varicella zoster virus.

Thoracocentesis for the hydrothorax was performed during the amniocentesis and about 50 ccs of fluid was drained. Follow up at 18 and 20 weeks revealed a residual of 6 and 2 mm of fluid respectively. At 24 weeks the lungs were seen to be normal with no hydrothorax or medistinal shift.
The woman had a full term normal delivery. The Apgar scores were normal and the neonate was discharged with mild jaundice.

Longitudinal and transverse scans at 16 weeks of gestation demonstrating right pleural effusion and contralateral shift of mediastinum:

Follow up longitudinal and transverse scans at 20 weeks of gestation demonstrating complete resolution:

Transverse scan of the contralateral normal side:

It is known that varicella zoster virus can cause sever pneumonia and limb defects in the fetus. This was the rationale behind performing PCR investigation of the amniotic fluid.

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