Etiology and outcome of non-immune hydrops fetalis in southern Thailand.
OBJECTIVE
To study the etiology and outcome of non-immune hydrops fetalis in southern Thailand.


METHODS
The medical records and videotape recordings of all pregnant women diagnosed with non-immune fetal hydrops, from January 1993 to December 2002 were reviewed.


RESULTS
Non-immune hydrops fetalis was documented in 71 cases. The causes of fetal hydrops were identified in 87.3%. Homozygous alpha-thalassemia-1 dominated as the cause of non-immune fetal hydrops (28.2%), followed by structural abnormalities (15.5%) and infection (12.7%). The underlying etiology remained unknown in 9 cases (12.7%). The overall survival rate of non-immune hydrops fetalis cases was 4.2%. Spontaneous regression occurred in 2 cases. Two cases were lost to follow up after initial evaluation. Termination of pregnancy was performed in 47 cases. There were 12 dead fetuses in utero, 2 stillbirths, 5 early neonatal deaths and only 3 cases survived.


CONCLUSIONS
Homozygous alpha-thalassemia-1 is the most common cause of non-immune hydrops fetalis in southern Thailand, and the overall prognosis of non-immune hydrops fetalis is poor. We suggest that an effective thalassemia-screening program for prevention and control of homozygous alpha-thalassemia-1 be established in all areas where the alpha-thalassemia-1 gene is prevalent.
Suwanrath-Kengpol
Chitkasaem
C
Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand. chitkasaem.k@psu.ac.th <chitkasaem.k@psu.ac.th>
Kor-anantakul
Ounjai
O
Suntharasaj
Thitima
T
Leetanaporn
Roengsak
R
D000293:Adolescent; D000328:Adult; D000782:Aneuploidy; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000150:complications; D006455:Hemoglobins, Abnormal; D006801:Humans; D015160:Hydrops Fetalis / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics; D007239:Infections / Q000150:complications; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D013785:Thailand
D006455:Hemoglobins, Abnormal; C030448:hemoglobin Bart's