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Thoracoamniotic shunting is an effective treatment for fetal pleural effusion. Catheter obstruction is a serious and frequently occurring phenomenon that often requires re-shunting; however, accurate diagnosis remains challenging. We present a case in which pulsed-wave Doppler and color flow mapping were used to evaluate fluid flow through a thoracoamniotic shunt catheter. The Doppler assessment revealed alternating fast inflow (median: 69.2 cm/s) and slow outflow (median: 19.0 cm/s) synchronized with fetal breathing movements. Following the cessation of fetal breathing movements, a continuous and steady outflow with a constant velocity was observed. This case highlights the potential utility of Doppler ultrasound in assessing catheter patency, providing valuable information for the diagnosis of catheter obstruction in thoracoamniotic shunting.
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http://dx.doi.org/10.1111/jog.70040 | DOI Listing |
J Obstet Gynaecol Res
September 2025
Fetal-Maternal Medicine, Obstetrics, Gifu Prefectural General Medical Center, Gifu, Gifu, Japan.
Thoracoamniotic shunting is an effective treatment for fetal pleural effusion. Catheter obstruction is a serious and frequently occurring phenomenon that often requires re-shunting; however, accurate diagnosis remains challenging. We present a case in which pulsed-wave Doppler and color flow mapping were used to evaluate fluid flow through a thoracoamniotic shunt catheter.
View Article and Find Full Text PDFEur J Pediatr Surg
June 2025
Division of Pediatric Surgery, University Hospital Cologne, Cologne, Germany.
Intrauterine thoracoamniotic shunting in fetuses with congenital pulmonary airway malformation (CPAM) was first described using Cook™ or Rocket™ shunts. With the availability of the Somatex™ intrauterine shunt, a new device with the supposed advantages of less invasive placement and less frequent dislocations, pediatric surgeons and neonatologists are increasingly confronted with a new cohort of patients. Data on postnatal findings and the impact on surgical management are scarce.
View Article and Find Full Text PDFFront Pediatr
May 2025
Clinical Area of Fetal, Neonatal and Cardiological Sciences and Research Area of Perinatal Medicine - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
Background: This study assesses the sensitivity and specificity of congenital pulmonary airway malformation (CPAM) Volume Ratio (CVR) in predicting the need for fetal therapy (FT) and explores the role of additional ultrasound indicators, including the Observed/Expected Lung to Head Ratio (O/E LHR) and Mediastinal Angle Shift (MSA), in improving FT prediction.
Methods: We retrospectively studied all CPAM cases referred to our Center from 2018 to 2022. FT was provided at any CVR value in cases of hydrops, rapid lesion growth, or polyhydramnios.
J Pediatr Urol
May 2025
Department of Urology, Division of Pediatric Urology, Stanford University School of Medicine and Lucile Packard Children's Hospital, Stanford, CA, United States.
Background: The suboptimal shunt design of the currently available vesico-amniotic and thoraco-amniotic shunts is likely at tributed to the risk of shunt failure, either by displacement, kinking, or obstruction, resulting in treatment failure and the need for additional fetal intervention.
Objective: To evaluate the feasibility of ultrasound-guided insertion, drainage, and short-term dislodgement risks of the novel Vortex shunt in fetal lambs with surgically induced lower urinary tract obstruction (LUTO) and pleural effusion.
Study Design: LUTO was surgically created in eight fetal lambs at a median of 71 days (range 69-72; term = 145) gestation.
JMA J
January 2025
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.