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Nonimmune Hydrops Fetalis: Factors Which Predict Outcome
Manisha Kumar1, Vandana Jha1, Anuradha Singh1
1Professor, Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, Bhagat Singh Marg, New Delhi, 110001 India.
Journal of Obstetrics and Gynaecology of India
|June 14, 2018
Summary
Non-immune hydrops fetalis (NIHF) is rarely caused by fetal anemia. Structural malformations, especially cardiac defects and cystic hygroma, significantly worsen the prognosis for NIHF cases.
Area of Science:
- Perinatology
- Fetal Medicine
- Genetics
Background:
- Non-immune hydrops fetalis (NIHF) is a complex condition with diverse etiologies.
- Identifying the causes and prognostic factors of NIHF is crucial for clinical management.
Purpose of the Study:
- To investigate the causes of NIHF in fetuses referred to a tertiary center.
- To analyze the outcomes and identify factors influencing survival in NIHF cases.
Main Methods:
- Retrospective review of 130 NIHF cases over eight years.
- Utilized antenatal ultrasound, blood tests, and postnatal examinations to determine causes and outcomes.
Main Results:
- Structural malformations were identified in 72.3% of NIHF cases, with cardiac abnormalities being most frequent (26.1%).
- Chromosomal abnormalities occurred in 11.5%, and fetal anemia was rare (3.1%).
- Live birth occurred in only 12.9% of cases; early onset, gastrointestinal malformations, and absence of structural defects were associated with live birth, while cystic hygroma and heart defects predicted poor outcomes.
Conclusions:
- Fetal anemia is an uncommon cause of NIHF.
- Early hydrops onset and the presence/type of structural malformations significantly impact prognosis.
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