{"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":1791732598656,"version":"4.3.4"},"reference-count":28,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Objective:&lt;\/i&gt;&lt;\/b&gt; Fetal thoraco-amniotic shunts (TASs) can dislodge in utero, migrating internally into the fetal thorax or externally into the amniotic cavity. Our objective was to evaluate the perinatal and long-term outcome of fetuses with TAS dislodgement and conduct a review of the literature. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; This is a retrospective review of all TAS inserted for primary pleural effusions and macrocystic congenital pulmonary airway malformations (CPAMs) in a tertiary fetal medicine center (1991\u20132020). Antenatal history, procedural factors, and perinatal and long-term outcomes were reviewed in all fetuses with dislodged shunts and compared to fetuses with shunts that did not dislodge. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; Of 211 TAS inserted at a mean gestational age of 27.8 weeks \u00b1 5.47 (17.4\u201338.1 weeks), 187 (89%) were inserted for pleural effusions and 24 (11%) for macrocystic CPAMs. Shunts dislodged in 18 fetuses (8.5%), 17 (94%) of which were for pleural effusions. Shunts migrated into the chest wall\/amniotic cavity or into the thorax among 7\/18 (39%) and 11\/18 (61%) fetuses, respectively. Eleven (61%) fetuses were initially hydropic, which resolved in 8 (72%) cases. Effusions were bilateral in 9 (50%), amnioreduction was required in 6 (33%), and fetal rotation in 8 cases (44%). Four (22%) fetuses underwent repeat shunting, 12 (67%) neonates required ventilatory support, and 2 (11%) neonates required chest tubes. There was no significant difference in technical factors or outcomes between infants with shunts that dislodged and those that did not. Among 11 intrathoracic shunts, 2 (18%) were removed postnatally and the remainder are in situ without any shunt-related or respiratory complications over a follow-up period of 9 months to 22 years. &lt;b&gt;&lt;i&gt;Conclusion:&lt;\/i&gt;&lt;\/b&gt; TAS dislodged antenatally in 8.5% of fetuses, with 2\/3 of shunts migrating into the thorax, and nearly 25% requiring re-shunting. Retained intrathoracic shunts were well tolerated and may not necessarily require surgical removal after birth. <\/jats:p>","DOI":"10.1159\/000515694","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T05:57:52Z","timestamp":1619762272000},"page":"430-439","source":"Crossref","is-referenced-by-count":19,"title":["Perinatal Outcome in Fetuses with Dislodged Thoraco-Amniotic Shunts"],"prefix":"10.1159","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4426-7631","authenticated-orcid":false,"given":"Nimrah","family":"Abbasi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory","family":"Windrim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Keunen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.G.R.","family":"Seaward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Van Mieghem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmond N.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob C.","family":"Langer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,4,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4709"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4989"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1883"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1768"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7507"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/pd.3840"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11084"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.11.019"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1159\/000448095"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.05.016"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21994"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3468(89)80509-3"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2000.00114.x"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1159\/000106350"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1159\/000082431"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2000.tb01342.x"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s004310050032"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2019.01.005"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198810273191706"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1159\/000196374"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-013-0565-x"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1808"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.02021.x"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1981.03320070058030"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2014.02.009"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2014.0133"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1159\/000264276"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1159\/000263848"}],"container-title":["Fetal Diagnosis and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/515694","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/515694","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:37:18Z","timestamp":1745426238000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000515694"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,7,29]]},"published-print":{"date-parts":[[2021,8,2]]}},"URL":"https:\/\/doi.org\/10.1159\/000515694","archive":["Portico"],"relation":{},"ISSN":["1015-3837","1421-9964"],"issn-type":[{"value":"1015-3837","type":"print"},{"value":"1421-9964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]}}}