{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T15:29:58Z","timestamp":1791732598116,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess short\u2010 and long\u2010term outcome in a cohort of fetuses diagnosed with hydrothorax (FHT) which underwent thoracoamniotic shunting <jats:italic>in utero<\/jats:italic>, and to examine the antenatal predictors of survival and of survival with normal neurodevelopmental outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective analysis of 132 fetuses that underwent thoracoamniotic shunting at our center between 1991 and 2014. Data were extracted from hospital obstetric and relevant neonatal intensive care and neonatal developmental follow\u2010up databases. Outcomes included survival to discharge and survival with normal neurodevelopmental outcome\u2009beyond 18\u2009months. Information on malformations, syndromes and genetic abnormalities were obtained from antenatal, postnatal and pediatric hospital records or by parent report. We compared pregnancy characteristics among those who survived <jats:italic>vs<\/jats:italic> non\u2010survivors and among those with normal neurodevelopmental outcome <jats:italic>vs<\/jats:italic> those who were abnormal or died. We explored whether there was a trend in survival over the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean gestational age at diagnosis of FHT was 25.6\u2009weeks. The fetus was hydropic at diagnosis in 61% of cases, 69% had bilateral effusions and 55% had bilateral shunts inserted. Other diagnoses were present in 24% of cases, two\u2010thirds of which were discovered only postnatally. There were 16 intrauterine and 30 neonatal deaths, with a 65% survival rate overall. The mean gestational age at delivery of liveborns was 35.4 (range, 26.9\u201341.6)\u2009weeks, and 88\/116 (76%) were preterm (&lt;\u200937\u2009weeks). Of 87 liveborn at the treatment center, 75% experienced some respiratory and\/or cardiovascular morbidity after birth, many with a lengthy hospital stay (mean, 36 (range, 1\u2013249)\u2009days). Overall, 84% of survivors were developmentally normal beyond 18\u2009months and outcomes were better when pleural effusions were isolated, 92% of these cases being neurodevelopmentally normal. There was no trend in survival or neurodevelopmental outcome over time. Despite the presence of FHT and neonatal respiratory issues, most (89%) of the 55 survivors with relevant follow\u2010up had no long\u2010term pulmonary complications. Gestational age at delivery was the only factor independently predictive of both survival and survival with normal neurodevelopmental outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>FHT is associated with other pathologies in a quarter of cases and carries a significant risk of prematurity, mortality and neonatal morbidity. The outcome is good in survivors but is best in isolated cases. Predictors of outcome at diagnosis are poor. Future improvement in diagnostics at time of identification of FHT may help to identify those that would benefit most from thoracoamniotic shunting. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.21994","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T16:38:06Z","timestamp":1582043886000},"page":"624-630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Short\u2010 and long\u2010term outcome following thoracoamniotic shunting for fetal hydrothorax"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0271-4720","authenticated-orcid":false,"given":"E. N.","family":"Kelly","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Seaward","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Ontario Fetal Centre, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X. Y.","family":"Ye","sequence":"additional","affiliation":[{"name":"Micare Research Centre, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Windrim","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Ontario Fetal Centre, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3034-6905","authenticated-orcid":false,"given":"T.","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Ontario Fetal Centre, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Keunen","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Ontario Fetal Centre, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4426-7631","authenticated-orcid":false,"given":"N.","family":"Abbasi","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Ontario Fetal Centre, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Chitayat","sequence":"additional","affiliation":[{"name":"Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Ontario Fetal Centre, Mount Sinai Hospital University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(89)80509-3"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000263586"},{"key":"e_1_2_6_4_1","first-page":"281","article-title":"Fetal pleural effusion: a review and meta\u2010analysis for prognostic indicators","volume":"79","author":"Weber AM","year":"1992","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_5_1","first-page":"261","volume-title":"Pleural Effusions","author":"Pettersen HN","year":"1997"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000020863"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.3840"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2007.09.004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7507"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)80016-0"},{"key":"e_1_2_6_11_1","volume-title":"Bayley Scales of Infant Development, 2nd edn","author":"Bayley N.","year":"1993"},{"key":"e_1_2_6_12_1","volume-title":"Bayley Scales of Infant and Toddler Development\u00ae, Third Edition (Bayley\u2010III\u00ae)","author":"Bayley N","year":"2005"},{"key":"e_1_2_6_13_1","volume-title":"Ages & Stages Questionnaires\u00ae, Third Edition (ASQ\u00ae\u20103). 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