Ms. Yu’s little baby survived the congenital chylothorax and was discharged from the Neonatal Intensive Care Unit of Peking Union Medical College Hospital  on March 25, 2021. The baby’s family and 17 members of the multidisciplinary team took a group photo at the door of NICU. The MDT was composed of professionals from the Department of Obstetrics, Pediatrics, Anesthesia, Ultrasound and Operating room. Everyone was so pleased with the good outcome.

Ms. Yu was 43 years old and had regular prenatal care at Obstetric Center of PUMCH. Severe fetal pleural effusion with resultant cardiac compression was detected by ultrasound at 27+6 weeks of gestation on January 13, 2021. Congenital chylothorax was diagnosed by thoracocentesis. The effusion progressed quickly, causing fetal ascites, edema and heart failure just after one week.

Thoracoamniotic shunt (TAS) was offered by the maternal fetal medicine obstetricians after detailed evaluation and consultation. For TAS, a double pigtail catheter was inserted in the fetal pleural cavity, allowing the fluid to drain into the amniotic sac. The surgery was performed successfully with the support of MDT. Remarkable relief of hydrothorax and normal intrauterine growth of the fetus were observed one week after TAS.

On the morning of Chinese New Year day, Ms. Yu reached her 32 weeks of gestation and visited emergency for the sudden rupture of the amniotic sac accompanied by threatened premature labor. Prof. Jiang Yulin and Dr. Lyu Yan rushed to hospital and urgent cesarean section was performed. Ms. Yu gave birth to a 2150g girl. The baby got a perfect Apgar score. And the position of the catheter was proved to be satisfactory. Prof. Ma Mingsheng and Dr. Ma Jingran took over the management of the baby and transferred her to NICU.

Due to premature labor and pleural effusion, the baby experienced progressive respiratory distress shortly after birth. Doctors and nurses of NICU collaborated to solve respiratory, nutritional and other difficult clinical problems. After staying in NICU for six weeks, the baby recovered well and met all the discharge criteria. Though the baby is back home, MDT at PUMCH will continue to ensure her healthy development by monitoring the baby growth, adjusting daily diet, and surveilling the changing trend of pleural effusion and serum biochemical levels.

Ms. Yu’s family presented a silk banner to the multidisciplinary team to express their gratitude.

Reporter: Fu Tanping

Correspondent: Jiang Yulin, Gou Lijuan, Tang Xiaoyan, Zhou Yu

Photo: Sun Liang

Translator: Lyn Yan

Editor: Yu Nanze