Prenatal diagnosis and management of nonimmunologic hydrops fetalis

As problem pregnancies are increasingly subjected to ultrasound evaluation, the prenatal diagnosis of hydrops fetalis is being made more and more frequently. The authors encountered 5 cases of this disorder in 12,830 deliveries (1:2566) and made the diagnosis prior to delivery in 4 of the 5 cases. Amniocentesis and amniotic fluid bilirubin determination have been performed in association with ultrasound scan and a battery of other diagnostic tests, and the results have been correlated with fetal outcome. In general the combination of fetal ascites and increased amniotic fluid bilirubin denotes a poor fetal prognosis. Unless there are other mitigating circumstances, a conservative course of management is recommended.