Fetal Pleural Effusion

Fetal pleural effusions (also known as fetal hydrothorax) are abnormal accumulations of fluid in the chest cavity. The fluid exists between the lungs and the chest wall and can be on the left, right or both sides. As the fluid increases, it can compress the other structures in the chest such as the lungs and heart. Severe pleural effusions can result in poor development of the lungs or heart failure. Causes of the pleural effusion may include infection, heart conditions, genetic or chromosome problems, abnormal lymph drainage or lung problems but in most cases are unknown.

Lung Lesion Prenatal Care Algorithm PDF

What Will Happen During Pregnancy?

A pleural effusion is typically diagnosed by ultrasound. If detected, your pregnancy will be closely monitored with ultrasounds to evaluate the severity of the fluid collection and determine if the fetus is any danger.

A specialized ultrasound of the fetal heart, called an echocardiogram, will be performed and an amniocentesis will be recommended to look for chromosomal anomalies.

In some cases, this fluid may spontaneously disappear.

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Most cases do not require fetal pleural effusion treatment. However, if the fluid accumulates enough to cause severe compression of the heart or lungs, fetal intervention may become necessary. Typically, the fluid in the chest cavity will either be drained once with a small needle, or continuously with a shunt. These pleural effusion treatment procedures are performed with local anesthesia and sedation under ultrasound guidance.

What Special Considerations Should Be Made for Delivery?

Type of delivery: Cesarean delivery is usually not necessary in pregnancies complicated by pleural effusions. The delivery plan should be discussed between you and your obstetrician.

Place of delivery: The baby should be delivered at a hospital that is well prepared to handle the needs and surgery required of infants with a pleural effusion. There should be a neonatal intensive care unit with the capability to provide specialized neonatal intensive care and pediatric surgery services.

Time of delivery: Unless fetal intervention is necessary to address serious complications due to the pleural effusion, there is usually no reason to intentionally induce early delivery and mothers can usually carry the child to term.

What Will Happen at Birth?

Immediately following delivery, doctors will carefully evaluate the baby and begin treatment as necessary. The baby will be stabilized in the neonatal intensive care unit to fully assess the lung and heart function. After delivery, a chest tube may be necessary to help drain the fluid. This will also allow sampling of the fluid to help determine the cause of the pleural effusion. The physicians at the Center will develop a comprehensive plan for you and your baby before, during, and after birth.

What Are the Long-Term Outcomes and Considerations?

Depending on the severity of the effusion and impairment of lung development, your newborn may have difficulty breathing. Most cases of pleural effusion are mild and children will grow up with normal lung function. Unfortunately, it is difficult to predict the severity of the lung damage based on prenatal ultrasounds or even shortly after birth.

The Center team will help care for you and your infant with a pleural effusion. The Center will develop a comprehensive pleural effusion treatment plan with all of the physicians and specialists involved in the care of you and your newborn.

When you contact The Fetal Center, you will be in touch with a dedicated coordinator who will walk you through the process step-by-step and help you to understand every aspect of your care.

The Fetal Center at Children's Memorial Hermann Hospital
UT Professional Building
6410 Fannin, Suite 210
Houston, Texas 77030

Phone: (832) 325-7288
Toll free: (888) 818-4818
Fax: (713) 383-1464
Email: thefetalcenter@memorialhermann.org

Located within the Texas Medical Center, The Fetal Center is affiliated with McGovern Medical School at UTHealth Houston, UT Physicians and Children’s Memorial Hermann Hospital.