The purpose of this study was to evaluate perinatal outcome after thoracoamnio tic shunting for fetal pleural effusions with hydrops. This was a retrospective study. Shunting was performed immediately after diagnosis and was successful in all 54 of the cases that were attempted. There were 7 pregnancy terminations, 9 in utero deaths, and 38 live births, of which 7 children died in the neonatal pe riod and 31 children survived. Among the liveborn infants, 27 infants were deliv ered preterm (71%), of whom 7 infants (15%) had preterm premature rupture of m embranes and 4 infants (8.5%) had chorioamnionitis. Perinatal death (23/54 infa nts; 43%) was related to underlying anomalies (7 cases), pulmonary hypoplasia ( 5 cases), chorioamnionitis (2 cases), or treatment failure for unknown reasons ( 9 cases). All 31 survivors had chylothorax; for 28 of the survivors, the chyloth orax was primary, and for 3 survivors, the chylothorax was the result of right c ongenital diaphragmatic hernia, pulmonary sequestration, or Noonan syndrome. Aft er the shunting, pleural effusion with hydrops has a 57%survival rate; prematur e delivery is the leading source of morbidity. The purpose of this study was to evaluate perinatal outcome after thoracoamnio tic shunting for fetal pleural effusions with hydrops. This was a recent retrospective study. Shunting was performed immediately after diagnosis and was successful in all 54 of the cases that were attempted. There were 7 pregnancy Terminals, 9 in utero deaths, and 38 live births, of which 7 children died in the neonatal pe riod and 31 children survived. Among the liveborn infants, 27 infants were deliv ered preterm (71%), of whom 7 infants (15% hadinternal death (23/54 infants; 43%) was related to the underlying anomalies (7 cases), pulmonary hypoplasia (5 cases), chorioamnionitis (2) had preterm rupture of m embranes and 4 infants (8.5%) had chorioamnionitis All 31 survivors had chylothorax; for 28 of the survivors, the chyloth orax was primary, and for 3 survivors, the chylothorax was the result of right c ongenital diaphragmatic hernia, pulmo nary sequestration, or Noonan syndrome. Aft er the shunting, pleural effusion with hydrops has a 57% survival rate; prematur e delivery is the leading source of morbidity.