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Non-immune hydrops after 20 weeks' gestation: review of 10 years' experience with suggestions for management
1Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill.
Objective:
To analyze the etiologies and outcomes for a southeastern section of the United States, and to organize an efficient approach to evaluation.
Methods:
We reviewed 82 cases of non-immune hydrops presenting after 20 weeks' gestation over a 10-year period.
Results:
Overall perinatal mortality was 86.6%. Fetuses diagnosed with hydrops before 24 weeks' gestation had a perinatal mortality of 95%, with nearly one-third having abnormal karyotypes. The etiology of hydrops diagnosed after 24 weeks' gestation was more likely to remain idiopathic or to be related to cardiothoracic abnormalities.
Conclusion:
Before 24 weeks' gestation, the high risk of mortality and abnormal karyotype justifies offering families funipuncture in the hope of finding a treatable cause of non-immune hydrops. After 24 weeks' gestation, when fewer abnormal karyotypes are found, funipuncture may also be pivotal in diagnosing the cause of non-immune hydrops.