Comparison of Insertion Difficulties and Performance of Thoracoamniotic Shunts for Fetal Hydrothorax
Bibliographic record
Abstract
OBJECTIVE: This study compared insertion difficulties, shunt failure, reintervention rates, maternal adverse events, and neonatal outcomes among different shunt types used in fetal hydrothorax. METHOD: A retrospective multicenter cohort study (2012-2022) was conducted across 12 international centers. The primary outcome was the occurrence of complications, classified as insertion difficulties and shunt failure (dislocation, occlusion, or unexplained shunt failure). Secondary outcomes included reintervention rates, maternal complications, and neonatal survival. RESULTS: Among 349 cases, 345 were included in the analysis of the outcome measures. Rodeck shunts had significantly fewer complications (19.5%) compared to Somatex (38.3%, OR 2.53, p = 0.016) and Harrison shunts (50.0%, OR 3.82, p < 0.001). Somatex shunts had the highest rate of incorrect positioning (16%), while dislocation was most frequent with Harrison shunts (31.1%). Reintervention rates were lowest for Rodeck (12.1%) and highest for Harrison (32.2%). Maternal body mass index, fetal hydrops, laterality and year of shunt placement did not significantly influence complication rates. No significant differences in live birth rates or gestational age at delivery were observed. CONCLUSIONS: The Rodeck shunt was associated with fewer insertion difficulties, better shunt performance and lower reintervention rates. There was no difference in perinatal survival among the three shunt types.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".