Shunt tóraco-amniótico: Experiencia de 5 años en la Unidad de Medicina Fetal del Hospital Universitari Vall D’hebron, Barcelona

Objetives: The aim of this study is to review all the cases with thoracoamniotic shunts placed between 2005-2009 at the Vall d’Hebron’s Universitari Hospital, Barcelona. Methods: Retrospective study of thoracoamniotic shunts (Somatex Shunt, Leleman Germany) placed at the Fetal Unit between 2005-2009. Inclusion criteria were hidrops, alterations in pulsatility of ductus venousus and risk of pulmonary hypoplasia. Results: A total of 20 cases were registered with ages among 21-40 years old (mean 26). The most common diagnostics were: chylothorax (55%), cystic adenomatoid malformation (20%), ductus agenesis (15%) and hydrothorax (10%). The average gestational age at the time of intervention was 28 weeks (range 25-34). Prenatal evolution: improved (65%), reintervention (25%) and associated fetal thoracocentesis (10%). The average gestational age at delivery was 33.5 weeks (range 27-40) with a mean birth weight of 2700grams (range 1500-3500). Perinatal outcome: healthy babies (85%), died (10%) and infected (5%). Discussion: Survival similar with another series (65%). Cases with cystic adenomatoid malformation type II better prognosis. Alternative strategies may be test with failures (25% of chylothorax). Preterm labour and perinatal infection are frequent obstetrical complications. Catheter migration is a consistent problem.