In the process of fetal growth and development, once the vital organs are "compressed", the situation can be tricky. Among them, fetal pleural effusion is a disease that often threatens the development of the heart and lungs.
25-year-old Yang Yue (pseudonym) thought that she could be successfully upgraded to a novice mother this year, but a B-ultrasound examination at 24 weeks of pregnancy found that there was a large amount of fluid in the left chest cavity of the fetus, which had affected the development of the lungs. The fetus is only 6 months old at the time, and if it develops, it may cause severe developmental abnormalities, and even heart failure may occur when the heart is compressed in the later stage.
Do you want to lose your baby because of this?
The 6-month-old fetus is treated with intrauterine surgery
Yang Yue and his wife were unwilling to give up, and immediately found Chief Physician Xiong Yu, deputy director (presiding over the work) of the Department of Fetal Medicine and Prenatal Diagnosis of Red House Hospital, and applied for a multidisciplinary consultation in fetal medicine. After discussion and evaluation by experts in obstetrics, neonatology, pediatric surgery, ultrasound, and imaging, it is believed that the baby's lungs are indeed compressed, but fortunately, the heart development is still normal. However, there is a certain degree of difficulty in intrauterine surgery, because the operation itself is a "limit" operation in the "tiny body" of the fetus, and the fetus also needs to maintain a specific posture and cooperate with the doctor, and there are risks of infection, premature birth, and premature rupture of membranes if there is a slight deviation.
Director Xiong Yu in the consultation
In the end, Yang Yue and his wife decided to give it a try and seek life for the baby. After amniocentesis ruled out other abnormalities, Shen Jie, deputy chief physician of the Department of Fetal Medicine and Prenatal Diagnosis at 25 weeks of pregnancy, first accurately performed thoracentesis for the baby in Yang Yue's belly, and then carefully inserted a drainage tube (commonly known as "pig tail tube") to help the baby discharge the fluid accumulated in the chest cavity into the amniotic cavity, "decompress" the heart and lungs, and then withdraw the tube in time after delivery.
Deputy Chief Physician Shen Jie (left) is undergoing intrauterine surgery
In the end, the operation was successfully completed, and Yang Yue passed the third trimester safely, and gave birth to a male baby naturally at 39+4 weeks of pregnancy, weighing 3140g, and the newborn score was 9 points. After timely drainage treatment by the neonatal department, the baby was discharged from the hospital in good health.
In the womb, a "pig's tail tube" helps the baby expel the effusion
In recent years, many pregnant mothers like Yang Yue have come to the fetal medicine department of Red House Hospital for fetal pleural effusion. Because the fetus does not need to breathe in the mother's womb, even if the lungs are completely immersed in the effusion, there will be no chest tightness or dyspnea, which is usually discovered incidentally during ultrasonography.
But no performance doesn't mean no danger!
If the fetus has a pleural effusion, the smaller the gestational age, the more serious the consequences
Director Xiong Yu introduced that if the baby's pleural effusion persists and increases, it will inevitably compress the developing lungs, and in severe cases, it will lead to lung dysplasia. If it compresses the heart, esophagus and other organs, it will also affect the baby's heart function or swallowing function, resulting in polyhydramnios and even heart failure. In addition, in addition to simple pleural effusion, the disease may also be a secondary manifestation of other developmental abnormalities, such as generalized edema of the baby caused by maternal and infant blood group disharmony, severe heart malformations and arrhythmias, intrauterine infection, chromosomal abnormalities, etc., in short, the smaller the gestational age of the baby, the more serious the consequences may be.
In terms of treatment, Director Shen Jie introduced that for simple pleural effusion, if the amount of fluid is small, there is a possibility of natural regression and absorption; if the amount is large, it has affected the normal development or function of surrounding organs, it may be necessary for fetal medical experts to carry out intrauterine surgery on the baby; if the fetus is close to term before serious pleural effusion, the baby can also be given birth first, and then the pediatrician will carry out follow-up treatment after birth.
The prognosis for fetuses with isolated pleural effusions is generally good, with survival rates reported in the literature to be greater than 90%. However, such fetuses must be delivered in a hospital with the ability to rescue neonatal asphyxia. Theoretically, if the pleural effusion does not cause compression and development of some vital organs, the baby's lungs can expand as scheduled, and the effusion will be slowly absorbed after active treatment by pediatricians such as thoracentesis drainage, respiratory support, and special formula feeding.
It is understood that the fetus may also be sick in the mother's womb, and the past practice is usually that parents have to choose to give up or risk extremely premature birth to let the baby be delivered early. Red House Hospital said that in recent years, through the Department of Prenatal Diagnosis and Fetal Medicine through intrauterine treatment technology, many unborn babies have won the opportunity of newborns, including fetoscopic placental vascular communication coagulation, radiofrequency ablation fetal reduction, potassium chloride fetal reduction, pleural effusion drainage, intrauterine blood transfusion surgery, amniotic fluid reduction, amniotic fluid infusion and other conventional intrauterine treatment procedures, with an overall success rate of more than 95% and a good maternal and fetal prognosis.