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All Journal Jurnal Pendidikan Dasar Nusantara PREMISE: Journal of English Education and Applied Linguistics Jurnal Studi Agama dan Masyarakat IDEAS: Journal on English Language Teaching and Learning, Linguistics and Literature Jurnal Pengabdian UntukMu NegeRI Linguistics and Elt Journal Jurnal Basicedu Deiksis Scope: Journal of English Language Teaching JOLLT Journal of Languages and Language Teaching PROFICIO: Jurnal Pengabdian Masyarakat JEdu: Journal of English Education Jurnal Basicedu JURNAL MUARA PENDIDIKAN Journal of Public Health Concerns Indonesian Research Journal on Education Proceeding of International Conference on Science, Education, and Technology EduInovasi: Journal of Basic Educational Studies AKSIOMA : Jurnal Sains Ekonomi dan Edukasi Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Nugroho Nugroho
Univeritas Indraprasta PGRI
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Anesthetic Considerations in a Neonate Undergoing Thoracoscopic Removal of a Thoraco-Amniotic Shunt Following Prenatal Management of Fetal Pleural Effusion: A Case Report Nugroho, Nugroho; Andi Ade Wijaya Ramlan
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.325

Abstract

Fetal pleural effusion is a condition characterized by the accumulation of fluid in the chest cavity of a developing fetus. It may be primary, often caused by lymphatic leakage such as chylothorax, or secondary to immune causes like Rh or ABO incompatibility, as well as nonimmune factors including chromosomal abnormalities, genetic disorders, infections, and congenital heart defects. These effusions may be associated with hydrops fetalis. The preferred prenatal treatment is thoraco-amniotic shunt (TAS), which drains pleural fluid into the amniotic sac. TAS improves lung development and has a survival rate of up to 85% in nonhydropic fetuses. A 34-week pregnant woman (gravida 2, para 1) was referred with suspected fetal lung fluid and diagnosed with fetal pleural effusion by ultrasound. After multidisciplinary evaluation, an ultrasound-guided thoraco-amniotic shunt (TAS) was performed under maternal spinal anesthesia, with fetal analgesia and paralysis achieved using fentanyl and vecuronium. The procedure was successful without complications. The patient delivered by cesarean section at 38 weeks. Postnatal imaging showed the shunt in place without residual effusion. On day six of life, the neonate underwent successful thoracoscopic shunt removal under general anesthesia, with stable intraoperative and postoperative outcomes. Conclusion, Thoraco-amniotic shunt placement and postnatal thoracoscopic removal require careful anesthetic planning and multidisciplinary coordination. Understanding maternal-fetal physiology and neonatal immaturity is essential. With thorough assessment and precise anesthetic management, both intrauterine and neonatal procedures can be performed safely with favorable outcomes.
Co-Authors Adi Permana Amelia , Nur Andi Ade Wijaya Ramlan Angga Setiawan Dina Dwi Nuryani Dirham, Ulfah Ridhwan Dwi Rorin M Insana Elisa, Edelia Firayanti, Yuni Ghozali, Derby Ibrahim, Nurdin Ilhaq, Muhsin Irfan Hadi Mardiansyah Mardiansyah, Mardiansyah Navila, Navila Nia Liska Saputri Nur Fitriyana Nurhayat, Arpah Rifari Baron Salsabilla, Shifa Sheila Melinia Sigit Widiyarto Solihatin, Etin Suryani Suryani Suwandi, Sahri Syaifudin, Syarif Muhammad Taupiqurrahman, R. M. Wahyu Nugroho Wibisono , Chandra Widyaningtyas, Dessy Yogi Purnama Zain, Zaki Faddad Syarif