{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T04:45:54Z","timestamp":1769661954018,"version":"3.49.0"},"reference-count":11,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Thoracoamniotic shunting (TAS) is a well-established fetal therapy for severe pleural effusions complicated by hydrops. Although survival in selected cases exceeds 60%, retained or migrated shunts can pose significant postnatal management challenges. Case presentation: We report a neonate with intrathoracic migration of a Somatex\u00ae shunt placed at 26 weeks\u2019 gestation for hydropic pleural effusion. Although initially asymptomatic, the infant developed recurrent pleural effusions requiring multiple readmissions. Thoracoscopic retrieval on day 76 of life allowed safe removal despite dense adhesions, leading to complete clinical resolution. Discussion: Retained thoracoamniotic shunts may remain asymptomatic or cause recurrent effusions, pneumothorax, or other complications. This case highlights the limitations of conservative management in the presence of clinical deterioration and supports timely surgical removal. Standardized criteria for intervention are lacking and urgently needed. Conclusions: In infants with retained TAS, recurrence of effusions or respiratory compromise should prompt active removal. Thoracoscopic retrieval is a safe and effective minimally invasive option.<\/jats:p>","DOI":"10.3390\/children13020182","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:56:12Z","timestamp":1769615772000},"page":"182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Challenges of Retained Thoracoamniotic Shunts in the Neonatal Period: A Case Report"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9297-0404","authenticated-orcid":false,"given":"Alejandro","family":"Madurga","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, La Paz University Hospital, 28046 Madrid, Spain"},{"name":"Faculty of Medicine, Universidad Aut\u00f3noma de Madrid, 28049 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Victoria","family":"L\u00f3pez Canelada","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Velayos","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"De la Torre","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenia Antol\u00edn","family":"Alvarado","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Luis","family":"Encinas","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"\u00c1lvarez Barrial","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, King\u2019s College Hospital NHS Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1002\/pd.70048","article-title":"Comparison of Insertion Difficulties and Performance of Thoracoamniotic Shunts for Fetal Hydrothorax: Success and Failure Rates in Different Shunt Types for Fetal Hydrothorax","volume":"46","author":"Treurniet","year":"2026","journal-title":"Prenat. Diagn."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"288","DOI":"10.31662\/jmaj.2024-0227","article-title":"Impact of cytokine concentrations on long-term neurological outcomes in fetal pleural effusions managed with thoracoamniotic shunt","volume":"8","author":"Imai","year":"2025","journal-title":"JMA J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1159\/000515694","article-title":"Perinatal outcome in fetuses with dislodged thoraco-amniotic shunts","volume":"48","author":"Abbasi","year":"2021","journal-title":"Fetal Diagn Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1159\/000515849","article-title":"The use of Somatex shunt for fetal pleural effusion: A cohort of 8 procedures","volume":"48","author":"Chung","year":"2021","journal-title":"Fetal Diagn Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e255760","DOI":"10.1136\/bcr-2023-255760","article-title":"Management dilemma in thoracoamniotic shunt migrations","volume":"16","author":"Tan","year":"2023","journal-title":"BMJ Case Rep."},{"key":"ref_6","first-page":"68","article-title":"Pneumothorax associated with a displaced thoracoamniotic Somatex shunt in an infant with congenital pulmonary airway malformation: A case report","volume":"31","author":"Chan","year":"2025","journal-title":"Hong Kong Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"702","DOI":"10.21037\/tp-20-74","article-title":"Thoracoscopic removal of a displaced thoracoamniotic shunt in a newborn with antenatal pleural effusion: A case report","volume":"9","author":"Sham","year":"2020","journal-title":"Transl. Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1007\/s00595-022-02535-2","article-title":"Thoracoscopic removal with fluoroscopic radiographic guidance of thoracoamniotic shunting catheters in newborns","volume":"52","author":"Muta","year":"2022","journal-title":"Surg. Today"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"bcr2016216324","DOI":"10.1136\/bcr-2016-216324","article-title":"Refractory tension pneumothorax as a result of an internally displaced thoracoamniotic shunt in an infant with congenital pulmonary airway malformation","volume":"2016","author":"Law","year":"2016","journal-title":"BMJ Case Rep."},{"key":"ref_10","first-page":"e70570","article-title":"Catheter displacement into the amniotic cavity by fetal movement after thoracoamniotic shunting","volume":"16","author":"Katsura","year":"2024","journal-title":"Cureus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jpedsurg.2022.10.028","article-title":"The long-term outcome following thoracoamniotic shunting for congenital malformations","volume":"58","author":"Muntean","year":"2023","journal-title":"J. Pediatr. Surg."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/2\/182\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T16:25:15Z","timestamp":1769617515000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/2\/182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["children13020182"],"URL":"https:\/\/doi.org\/10.3390\/children13020182","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]}}}