OK-432 Treatment of Early Fetal Chylothorax: Pregnancy Outcome and Long-Term Follow-Up of 14 Cases.


Journal

Fetal diagnosis and therapy
ISSN: 1421-9964
Titre abrégé: Fetal Diagn Ther
Pays: Switzerland
ID NLM: 9107463

Informations de publication

Date de publication:
2019
Historique:
received: 05 02 2018
accepted: 02 05 2018
pubmed: 4 10 2018
medline: 2 7 2020
entrez: 4 10 2018
Statut: ppublish

Résumé

The treatment options for fetal chylothorax include thoracocentesis, thoracoamniotic shunting, and pleurodesis using OK-432. Knowledge on the long-term outcomes after treatment with OK-432 is limited. The aim of this study was to assess the long-term outcomes of children treated in utero with OK-432. We performed follow-up on pregnancies and children treated in utero with OK-432 between 2003 and 2009 at Copenhagen University Hospital Rigshospitalet for pleural effusions at gestational age (GA) 16+0-21+6 weeks. Anamnestic information, physical examination, pulmonary function test, neuropediatric examination, and intelligence testing using the Wechsler Intelligence Scale were used for evaluation. Fourteen cases, all chylothorax, were treated with OK-432. None had preterm premature rupture of membranes (PPROM), and the median GA at delivery was 38+5 (24+4-41+5) weeks. Twelve children were eligible for follow-up. The median age at follow-up was 11.4 (7.8-13.8) years. Pulmonary function was normal in all children and the mean full-scale IQ did not differ from that of normal children. Four children had a diagnosed medical condition, attention deficit disorder, or genetic syndrome. The remaining children had normal follow-up. Children treated with OK-432 have comparable survival rates and long-term neurodevelopmental outcomes to those treated with thoracoamniotic shunts. There seems to be a lower risk of procedure-related PPROM.

Sections du résumé

BACKGROUND BACKGROUND
The treatment options for fetal chylothorax include thoracocentesis, thoracoamniotic shunting, and pleurodesis using OK-432. Knowledge on the long-term outcomes after treatment with OK-432 is limited.
OBJECTIVE OBJECTIVE
The aim of this study was to assess the long-term outcomes of children treated in utero with OK-432.
METHODS METHODS
We performed follow-up on pregnancies and children treated in utero with OK-432 between 2003 and 2009 at Copenhagen University Hospital Rigshospitalet for pleural effusions at gestational age (GA) 16+0-21+6 weeks. Anamnestic information, physical examination, pulmonary function test, neuropediatric examination, and intelligence testing using the Wechsler Intelligence Scale were used for evaluation.
RESULTS RESULTS
Fourteen cases, all chylothorax, were treated with OK-432. None had preterm premature rupture of membranes (PPROM), and the median GA at delivery was 38+5 (24+4-41+5) weeks. Twelve children were eligible for follow-up. The median age at follow-up was 11.4 (7.8-13.8) years. Pulmonary function was normal in all children and the mean full-scale IQ did not differ from that of normal children. Four children had a diagnosed medical condition, attention deficit disorder, or genetic syndrome. The remaining children had normal follow-up.
CONCLUSION CONCLUSIONS
Children treated with OK-432 have comparable survival rates and long-term neurodevelopmental outcomes to those treated with thoracoamniotic shunts. There seems to be a lower risk of procedure-related PPROM.

Identifiants

pubmed: 30282075
pii: 000489775
doi: 10.1159/000489775
doi:

Substances chimiques

Picibanil 39325-01-4

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

81-87

Informations de copyright

© 2018 S. Karger AG, Basel.

Auteurs

Lone Nikoline Nørgaard (LN)

Department of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark, lonenoergaard@dadlnet.dk.

Ulrikka Nygaard (U)

Department of Pediatrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Julie Agner Damm (JA)

Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Barbara Hoff Esbjørn (BH)

Department of Psychology, University of Copenhagen, Copenhagen, Denmark.

Mette Marie Agner Pedersen (MMA)

Department of Psychology, University of Copenhagen, Copenhagen, Denmark.

Amanda Rottbøll (A)

Department of Psychology, University of Copenhagen, Copenhagen, Denmark.

Connie Jørgensen (C)

Emma Ultraljudsklinik, Malmö, Sweden.

Karin Sundberg (K)

Department of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

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