Obstet Gynecol Sci.  2015 Mar;58(2):90-97. 10.5468/ogs.2015.58.2.90.

Clinical characteristics and perinatal outcome of fetal hydrops

• Yeom W
• Paik ES
• An JJ
• Oh SY
• Choi SJ
• Roh CR
• Kim JH

• KMID: 2314031
• DOI: http://doi.org/10.5468/ogs.2015.58.2.90

Abstract

OBJECTIVE
To investigate the clinical characteristics of fetal hydrops and to find the antenatal ultrasound findings predictive of adverse perinatal outcome.
METHODS
This is a retrospective study of 42 women with fetal hydrops who delivered in a tertiary-referral center from 2005 to 2013. Fetal hydrops was defined as the presence of fluid collection in > or =2 body cavities: ascites, pleural effusion, pericardial effusion, and skin edema. Predictor variables recorded included: maternal characteristics, gestational age at diagnosis, ultrasound findings, and identifiable causes. Primary outcome variables analyzed were fetal death and neonatal death.
RESULTS
The mean gestational age at diagnosis was 29.3+/-5.4 weeks (range, 18 to 39 weeks). The most common identifiable causes were cardiac abnormality (10), followed by syndrome (4), aneuploidy (3), congenital infection (3), twin-to-twin transfusion syndrome (3), non-cardiac anormaly (2), chorioangioma (2), inborn errors of metabolism (1), and immune hydrops by anti-E antibody isoimmunization (1). Thirteen cases had no definite identifiable causes. Three women elected termination of pregnancy. Fetal death occurred in 4 cases. Among the 35 live-born babies, only 16 survived (54.0% neonatal mortality rate). Fetal death and neonatal mortality rate was not significantly associated with Doppler velocimetry indices or location of fluid collection, but increasing numbers of fluid collection site was significantly associated with a higher risk of neonatal death.
CONCLUSION
The incidence of fetal hydrops in our retrospective study was 24.4 per 10,000 deliveries and the perinatal mortality rate was 61.9% (26/42). The number of fluid collection sites was the significant antenatal risk factor to predict neonatal death.

Keyword

Fetal death in utero; Hydrops fetalis; Infant mortality; Ultrasonography

MeSH Terms

Aneuploidy
Ascites
Diagnosis
Edema
Female
Fetal Death
Fetofetal Transfusion
Gestational Age
Hemangioma
Humans
Hydrops Fetalis*
Incidence
Infant
Infant Mortality
Metabolism, Inborn Errors
Pericardial Effusion
Perinatal Mortality
Pleural Effusion
Pregnancy
Retrospective Studies
Rheology
Risk Factors
Skin
Ultrasonography

Figure

• 

  Fig. 1 A flowchart of the pregnancy and perinatal outcome of the pregnancies with fetal hydrops.

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