Korean J Obstet Gynecol.  2009 Jul;52(7):752-758.

Successful antenatal treatment of early fetal chylothorax with OK-432 pleurodesis

• Yim GW
• Kwon JY
• Park YW
• Kim YH

Abstract

Fetal chylothorax is a rare congenital manifestation that shows variable clinical outcome ranging from complete spontaneous resolution to progression into hydrops or lung hypoplasia. There is no consensus in the literature as to the optimal antenatal management despite several complications such as preterm delivery, pulmonary hypoplasia, and perinatal death. Pleuroamniotic shunting has been the treatment of choice in fetal chylothorax. Recently, new fetal therapy such as OK-432 (Picibanil) pleurodesis is being introduced. Herein, we present two cases of women referred at early 2nd trimester because of fetal hydrothorax by routine ultrasonography. Cytology obtained by thoracocentesis revealed abundant lymphocytes, suggesting chylothorax. Effusion was aspirated and OK-432 (Picibanil) was injected into the pleural space of fetus. On follow up ultrasonography, the pleural effusion was nearly resolved by adhesion of the intrathoracic space and resulted in the delivery of a healthy neonate. Intrapleural OK-432 injection may be feasible therapeutic option for selected cases in early 2nd trimester with persistent chylothorax for effective control of pleural effusion with no adverse effects.

Keyword

Chylothorax; Pleural effusion; Pleurodesis; Picibanil

MeSH Terms

Chylothorax
Consensus
Edema
Female
Fetal Therapies
Fetus
Follow-Up Studies
Humans
Hydrothorax
Infant, Newborn
Lung
Lymphocytes
Picibanil
Pleural Effusion
Pleurodesis
Picibanil