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KMID : 1040120160020010017
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Evidence and Values in Healthcare
2016 Volume.2 No. 1 p.17 ~ p.23
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In-utero fetal thoraco-amniotic shunt operation using basket-shaped catheter: a systematic review
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윤진희:Yoon Jin-Hee
조선영:Jo Sun-Youg/설아람:Sul Ah-Ram/김석현:Kim Seok-Hyun
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Abstract
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Objectives: To determine the safety and effectiveness of thoraco-amniotic shunt operation using basket-shaped catheter
in fetuses with chest lesions.
Methods: Database search was performed in 8 Korean databases, Ovid-MEDLINE, Ovid-EMBASE and Cochrane Library.
Related articles were selected if thoraco-amniotic shunt operation with basket-shaped catheter after thoracocentesis
was carried out due to fluid retention. Article selection and quality assessment were performed by two reviewers.
Results: Out of 657 articles selected, 3 papers were included in final assessment. There was no intervention-related
death and were reported intervention-related complications such as placental bleeding (6.7%), polyhydramnios
(30%~55%), pregnancy-induced hypertension (4.2%), mirror syndrome (12.5%) and catheter obstruction/displacement
(6.7%~38%/5~20%). In one comparative study, shunts were inserted into 15 fetuses, of whom 6 neonates (40%) died,
whereas of 13 fetuses with serial thoracocentesis, 5 (38.5%) died in utero and 3 neonates (23.1%) died. In two single-arm
studies, the perinatal survival rate were 75%~100%.
Conclusion: Thoraco-amniotic shunt operation with a basket-shaped catheter is associated with favorable outcome compared
with serial thoracocentesis and should be considered as a safe and effective procedure for drainage of chest fluid.
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KEYWORD
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Thoracoamniotic shunt, Fetal therapies, Basket-shaped catheter
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