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Fetal hydrothorax is a congenital anomaly primary due to leakage of lymphatic fluid into the pleural space. Cases with massive pleural effusions associated with hydrops are at a higher risk of perinatal death. For those at-risk cases, pleuroamniotic shunt (PAS) placement has demonstrated to be an effective fetal therapy to improve survival. However, such intervention is associated with risks of preterm rupture of membranes (PPROM) and preterm birth, which leads to a detrimental effect on neonatal survival1, 2 . In a recent study, preope