Postnatal Outcome of a Congenital Chylothorax Managed Antenatally with an Intrauterine Intervention

Congenital chylothorax is a rare but serious condition in neonates with nearly 50% mortality. We present a case of congenital chylothorax first detected at 23 weeks. Due to pleural effusion persisting despite pleurocentesis and amniodrainage, a thoracoamniotic shunt was placed by our foetal medicine team antenatally for large pleural effusions bilaterally with hydrops to help alleviate mediastinal compression. The neonate was born preterm at 30 weeks due to abruptio placentae via emergency caesarean section. The neonate responded well to a brief period of mechanical ventilation, intercostal drain insertion for pleural effusion, medium-chain triglyceride feeds and octreotide and was successfully discharged at 7 weeks of age without any comorbidities. Early detection and timely intervention with thoracoamniotic shunt help prevent lung hypoplasia, which is a major cause of death in these neonates.