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September 17, 1982

Congenital Bilateral Chylothorax: Antepartum Diagnosis and Successful Intrauterine Surgical Management

JAMA. 1982;248(11):1360-1361. doi:10.1001/jama.1982.03330110056030

ULTRASOUND imaging continues to be one of the most important diagnostic modalities available to the practicing obstetrician. However, the antenatal diagnosis of increasingly more complex pathological disorders in the fetus can complicate management plans. We report herein a case involving a recently recognized fetal problem and an innovative and successful technique of intrapartum intervention.

Report of a Case  A 26-year-old woman, gravida 2, para 1, was referred for diagnostic ultrasound at 36 weeks' gestation because of a rapid increase in fundal height, abdominal discomfort, and respiratory distress. Her first pregnancy had ended in the vaginal delivery of a normal 3,700-g infant after an uncomplicated pregnancy. There was no family history of congenital defects. The patient was not a diabetic. The present pregnancy had been complicated at 33 weeks by severe indigestion diagnosed by endoscopy as gastritis and duodenitis, for which she had been treated with cimetidine.The first ultrasound examination