Catheter Displacement Into the Amniotic Cavity by Fetal Movement After Thoracoamniotic Shunting

Thoracoamniotic shunting (TAS) is an effective treatment for fetal pleural effusion. We report a case of bilateral fetal pleural effusion in which catheter displacement into the amniotic cavity occurred due to fetal movement after TAS. Initially, left TAS was performed twice using a 60-mm catheter, resulting in displacement and the catheter being pinched between the fetal fingers. Subsequently, a 50-mm catheter was employed for left TAS, which successfully prevented further displacement. Labor was induced at 35 weeks and three days of gestation due to an increase in right fetal pleural effusion. Following delivery, the infant was managed with directional positive airway pressure and drainage of the pleural effusion and remained stable on respiratory support. This case highlights the importance of tailoring catheter length and placement based on the thickness of the fetal chest wall to minimize displacement risks associated with fetal movement.