Successful in utero Percutaneous Fetoscopic Release of a Wrapped Pleuro-Amniotic Shunt around the Fetal Arm: Case Report and Review of the Literature.

Abstract:

BACKGROUND AND OBJECTIVES:Fetal pleural effusions are either primary or secondary to chromosomal or structural fetal abnormalities. In both cases, thoraco-amniotic shunts may be indicated to prevent life-threatening consequences. In this report, we describe a rare complication of shunts and successful in utero management of this complication. We also summarize the prior reports of shunt wrapping around fetal limbs and successful prenatal release of the shunts. DATA SOURCE:Search including PubMed, MEDLINE and EMBASE databases from inception till November 2015 was conducted for cases with shunt entrapment around fetal limbs with or without prenatal management. RESULTS:Four cases including our case have been reported in the literature with wrapping of shunts around fetal limbs. Three of these cases were successfully managed prenatally using different interventional and anesthetic techniques. CONCLUSIONS:Prenatal shunts could be rarely complicated by wrapping of the shunt around fetal limbs with possible serious vascular and neurological consequences. Different techniques have been described for prenatal management of this condition. We describe a less invasive approach that could be done under local anesthesia in suitable cases.

journal_name

Fetal Diagn Ther

authors

Nassr AA,Ruano R,Espinoza J,Shamshirsaz AA

doi

10.1159/000450606

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

156-160

issue

2

eissn

1015-3837

issn

1421-9964

pii

000450606

journal_volume

43

pub_type

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