Prenatal diagnosis and management of nonimmune hydrops fetalis.
We examined the incidence, aetiological factors and outcome in 40 cases of nonimmune hydrops fetalis (NIH) and suggest a rational approach to management. The incidence of NIH was 1 in 830 deliveries during the last 10-year period. In spite of extensive antenatal and postnatal investigation no cause could be established in 14 (35%) cases. A probable aetiological factor was found in 65% of cases. These included viral infection (7), cardiovascular (6), twin-to-twin transfusion (3), chromosomal abnormality (3), other malformation syndromes (4), renal dysplasia (1), laryngeal atresia (1) and severe fetomaternal haemorrhage (1). Five of the 40 fetuses survived, 2 treated antenatally for tachyarrhythmia, 2 had spontaneous resolution and the fifth fetus had repeated intrauterine transfusions because of human parvovirus B19-induced anaemia. After diagnosis of nonimmune hydrops fetalis, early referral to a tertiary centre is to be encouraged for investigation and provision of intensive perinatal care. Investigation allows parents to be counselled appropriately that the mortality is no longer 100% and a steadily growing number may be amenable to some form of fetal therapy.
Swain
S
S
Department of Obstetrics and Gynaecology, The Queen Mother's Hospital, Glasgow, Scotland.
Cameron
A D
AD
McNay
M B
MB
Howatson
A G
AG
D000293:Adolescent; D000328:Adult; D006801:Humans; D015160:Hydrops Fetalis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal