Fetal thoracocentesis Archives - Revista Brasileira de Ginecologia e Obstetrícia

Purpose: to evaluate the possibility and accuracy of fetal karyotyping in pleural effusions. Methods: we studied fifteen fetuses with unilateral or bilateral pleural effusions. All of these fetuses underwent intrauterine thoracocentesis guided by ultrasound examinations. The gestational age varied from 19 to 34 weeks. A morphogenetic ultrasound examination was performed in each case by the authors in order to identify associated structural anomalies. When the cellular cultures of pleural effusion samples were negative, an alternative karyotype was obtained by cordocentesis. A fetal lymphocyte culture was made of pleural effusion samples for karyotype in a similar technique as for fetal blood. Results: the fetal karyotype was successful in 12 cases. There were 4 abnormal results, all of them were Down syndromes, and in the other 8 cases the chromosomal analyses were normal. The fetal karyotype was confirmed and compared by newborn blood chromosomal analysis, genetic evaluation or necropsy. There were no maternal or fetal side effects related to the procedure. Conclusions: the fetal karyotyping performed in pleural effusions obtained by intrauterine thoracocentesis proved to be highly efficient and safe. It must be the method of choice for rapid karyotyping in fetuses with pleural edema.