Perinatal Outcomes of Pleuro-Amniotic Shunting in Isolated Pleural Effusions: Systematic Review and Meta-analysis.

IF 4.7 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2026-10-11 DOI:10.1007/s12325-026-03809-8

Enzo Lofredo Amorim, Edward Araujo Júnior, Mucio Cevulla da Silva Lourenço, Daniel Giatti de Sousa, Felipe Muniz Ferreira, Maria Fernanda Dos Santos Lobo, Henrique Provinciatto, Eduardo Moreira Nader, Antonio Braga, Roberta Granese

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引用次数: 0

Abstract

Introduction: Pleuro-amniotic shunting has been proposed for fetal pleural effusion, although its safety and efficacy remain uncertain. Therefore, we aimed to evaluate the perinatal outcomes of the fetal therapy for isolated pleural effusion through a systematic review and single-arm meta-analysis.

Methods: PubMed/MEDLINE, Embase, Scopus, and Cochrane Central were searched for studies reporting outcomes of fetuses undergoing pleuro-amniotic shunting for isolated pleural effusion. The primary outcomes were overall survival and resolution of fetal hydrops. Single-arm random-effects meta-analyses were performed to estimate pooled event rates with 95% confidence intervals (CI).

Results: Ten retrospective cohort studies comprising 416 fetuses treated with pleuro-amniotic shunting were included. The pooled overall survival rate was 65.36% (95% CI 59.46-70.83; I² = 30.7%). Resolution of fetal hydrops occurred in 62.25% of cases (95% CI 54.27-69.62; I² = 0%). A total of 62 catheter displacements were recorded, corresponding to a combined prevalence of 17.13% (95% CI 13.59-21.36). Overall, there were 155 preterm births, resulting in a pooled prevalence of 69.67% (95% CI 61.24-76.95; I² = 26.9%). Preterm premature rupture of membranes (PPROM) prevalence was 17.65% (95% CI 7.78-35.28; I² = 84.5%; p < 0.001).

Conclusion: Pleuro-amniotic shunting achieves overall survival in approximately two-thirds of treated fetuses and resolving fetal hydrops in most cases. However, the procedure may be associated with preterm birth and PROM, underscoring the need for multidisciplinary perinatal management. Although the evidence is limited, these findings support pleuro-amniotic shunting as a promising treatment for progressive isolated fetal pleural effusion and highlight the need for prospective studies to optimize patient selection and perinatal care.

查看原文本刊更多论文

孤立性胸腔积液中胸膜-羊膜分流的围产儿结局：系统回顾和荟萃分析。

引言：尽管其安全性和有效性尚不确定，但已提出采用胸膜-羊膜分流术治疗胎儿胸腔积液。因此，我们旨在通过系统综述和单臂荟萃分析来评估胎儿治疗孤立性胸腔积液的围产儿结局。方法：检索PubMed/MEDLINE、Embase、Scopus和Cochrane Central中报道因孤立性胸腔积液而进行胸膜-羊膜分流术的胎儿结果的研究。主要结局是总生存和胎儿水肿的消退。随访时间随机进行了荟萃分析,估计集中事件率和95%可信区间(CI)。结果：纳入了10项回顾性队列研究，包括416例经胸膜-羊膜分流术治疗的胎儿。合并总生存率为65.36% （95% CI 59.46 ~ 70.83; I2 = 30.7%）。62.25%的胎儿积水得以解决（95% CI 54.27 ~ 69.62; I2 = 0%）。共记录62例导管移位，合计患病率为17.13% （95% CI 13.59-21.36）。总体而言，155例早产，导致总患病率为69.67% （95% CI 61.24-76.95; I2 = 26.9%）。早产胎膜早破（PPROM）患病率为17.65% （95% CI 7.78-35.28; I2 = 84.5%; p）结论：胸膜-羊膜分流术在约三分之二的治疗胎儿中实现了总生存率，并在大多数情况下解决了胎儿积液。然而，该程序可能与早产和胎膜早破有关，强调需要多学科围产期管理。尽管证据有限，但这些发现支持胸膜-羊膜分流术作为进行性孤立性胎儿胸腔积液的一种有希望的治疗方法，并强调需要前瞻性研究来优化患者选择和围产期护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.