Effects of intrauterine treatment on nonimmunologic hydrops fetalis

In 44 cases with nonimmunologic hydrops fetalis (NIHF), perinatal management was performed based on our protocol. Twenty-one cases were treated by albumin and/or packed red blood cell (PRC) injection into the fetal abdominal cavity, and 8 cases were treated by transplacental digitalization. Among the cases treated by albumin and/or PRC injection, 5 of 7 cases without pleural effusion recovered in utero, and all 5 cases are alive at the time of writing. However, of 14 cases with pleural effusion, none recovered in utero, and only 1 case is alive. Of 8 cases treated by transplacental digitalization, 2 cases recovered in utero, and 1 case is alive. All fetuses with congenital heart anomaly died. This evidence indicates that albumin and/or PRC injection into the fetal abdominal cavity is an effective procedure for in utero treatment of NIHF without pleural effusion, but suggests that in NIHF resulting from either congenital heart anomaly and/or heart failure, the survival rate may not be increased by transplacental digitalization.