Systematic review of pleural-amniotic shunt insertion vs. conservative management in isolated bilateral fetal hydrothorax without hydrops

Elaine Carson, Priscilla Devaseelan, Stephen Ong

Research output: Contribution to journalReview article

Abstract

OBJECTIVE: In the management of bilateral fetal hydrothorax where the fetus is non-hydropic and apparently otherwise normal, we wished to determine if pleural-amniotic shunt insertion was better than conservative management in terms of mortality.

METHODS: A systematic review was conducted between 1992 and 2017. Data extracted was inspected for heterogeneity. Where there was comparative data available, the odds ratio (OR) and confidence interval (CI) were calculated.

RESULTS: Seven studies were included in this systematic review. There was a paucity of comparative data where only 2 studies (28 cases) allowed for direct comparison. Within the limitations of the study, there was no difference between shunt insertion vs. conservative management in terms of stillbirth or miscarriage (OR = 1.00, 95% CI 0.12-8.34, heterogeneity I2 = 0%, p = 1.00).

CONCLUSION: There is insufficient data available to determine whether the outcome is improved by pleural-amniotic shunt insertion compared with conservative management in cases of bilateral fetal hydrothorax where the fetus is non-hydropic and otherwise normal.

Original languageEnglish
JournalIrish journal of medical science
Early online date19 Nov 2019
DOIs
Publication statusEarly online date - 19 Nov 2019
Externally publishedYes

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Hydrothorax
Edema
Fetus
Odds Ratio
Confidence Intervals
Stillbirth
Spontaneous Abortion
Mortality
Conservative Treatment

Cite this

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title = "Systematic review of pleural-amniotic shunt insertion vs. conservative management in isolated bilateral fetal hydrothorax without hydrops",
abstract = "OBJECTIVE: In the management of bilateral fetal hydrothorax where the fetus is non-hydropic and apparently otherwise normal, we wished to determine if pleural-amniotic shunt insertion was better than conservative management in terms of mortality.METHODS: A systematic review was conducted between 1992 and 2017. Data extracted was inspected for heterogeneity. Where there was comparative data available, the odds ratio (OR) and confidence interval (CI) were calculated.RESULTS: Seven studies were included in this systematic review. There was a paucity of comparative data where only 2 studies (28 cases) allowed for direct comparison. Within the limitations of the study, there was no difference between shunt insertion vs. conservative management in terms of stillbirth or miscarriage (OR = 1.00, 95{\%} CI 0.12-8.34, heterogeneity I2 = 0{\%}, p = 1.00).CONCLUSION: There is insufficient data available to determine whether the outcome is improved by pleural-amniotic shunt insertion compared with conservative management in cases of bilateral fetal hydrothorax where the fetus is non-hydropic and otherwise normal.",
author = "Elaine Carson and Priscilla Devaseelan and Stephen Ong",
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language = "English",
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Systematic review of pleural-amniotic shunt insertion vs. conservative management in isolated bilateral fetal hydrothorax without hydrops. / Carson, Elaine; Devaseelan, Priscilla; Ong, Stephen.

In: Irish journal of medical science, 19.11.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Systematic review of pleural-amniotic shunt insertion vs. conservative management in isolated bilateral fetal hydrothorax without hydrops

AU - Carson, Elaine

AU - Devaseelan, Priscilla

AU - Ong, Stephen

PY - 2019/11/19

Y1 - 2019/11/19

N2 - OBJECTIVE: In the management of bilateral fetal hydrothorax where the fetus is non-hydropic and apparently otherwise normal, we wished to determine if pleural-amniotic shunt insertion was better than conservative management in terms of mortality.METHODS: A systematic review was conducted between 1992 and 2017. Data extracted was inspected for heterogeneity. Where there was comparative data available, the odds ratio (OR) and confidence interval (CI) were calculated.RESULTS: Seven studies were included in this systematic review. There was a paucity of comparative data where only 2 studies (28 cases) allowed for direct comparison. Within the limitations of the study, there was no difference between shunt insertion vs. conservative management in terms of stillbirth or miscarriage (OR = 1.00, 95% CI 0.12-8.34, heterogeneity I2 = 0%, p = 1.00).CONCLUSION: There is insufficient data available to determine whether the outcome is improved by pleural-amniotic shunt insertion compared with conservative management in cases of bilateral fetal hydrothorax where the fetus is non-hydropic and otherwise normal.

AB - OBJECTIVE: In the management of bilateral fetal hydrothorax where the fetus is non-hydropic and apparently otherwise normal, we wished to determine if pleural-amniotic shunt insertion was better than conservative management in terms of mortality.METHODS: A systematic review was conducted between 1992 and 2017. Data extracted was inspected for heterogeneity. Where there was comparative data available, the odds ratio (OR) and confidence interval (CI) were calculated.RESULTS: Seven studies were included in this systematic review. There was a paucity of comparative data where only 2 studies (28 cases) allowed for direct comparison. Within the limitations of the study, there was no difference between shunt insertion vs. conservative management in terms of stillbirth or miscarriage (OR = 1.00, 95% CI 0.12-8.34, heterogeneity I2 = 0%, p = 1.00).CONCLUSION: There is insufficient data available to determine whether the outcome is improved by pleural-amniotic shunt insertion compared with conservative management in cases of bilateral fetal hydrothorax where the fetus is non-hydropic and otherwise normal.

U2 - 10.1007/s11845-019-02094-5

DO - 10.1007/s11845-019-02094-5

M3 - Review article

C2 - 31745722

JO - Irish journal of medical science

JF - Irish journal of medical science

SN - 0021-1265

ER -