Hydrops fetalis--has there been a change in diagnostic spectrum and mortality?
OBJECTIVE
To investigate the impact of medical progress on the diagnostic spectrum and outcome of infants with hydrops fetalis (HF).


METHODS
We reviewed the charts of all live-born HF infants (n = 70) over a 16-year period (1993-2009). Data were compared to two published case series (Wafelman LS, Pollock BH, Kreutzer J, Richards DS, Hutchison AA. Biol Neonate 1999;75:73-81, Gainesville, Florida 1983-1992, n = 62; Simpson JH, McDevitt H, Young D, Cameron AD. Fetal Diagn Ther 2006;21:380-382, Glasgow, UK 1990-2004, n = 30).


RESULTS
Only two cases were immune HF. The proportion of infants with unexplained HF (30%), lymphatic (24%), cardiac (17%), hematological (6%) or chromosomal anomalies (6%) did not differ from the published case series. There was also no difference in overall mortality (57% vs. 55% or 67%, respectively). Low gestational age (<34 weeks), low 5-min Apgar scores (<4), and heart failure were independently associated with fatality.


CONCLUSIONS
The diagnostic spectrum and mortality of HF has changed little over the last 25 years. In the future, new techniques in mutational analysis will be needed to reduce the high rate of unexplained cases of HF.
Czernik
Christoph
C
Department of Neonatology, Charité University Medical Center, Berlin, Germany.
Proquitté
Hans
H
Metze
Boris
B
Bührer
Christoph
C
D001723:Birth Rate; D015331:Cohort Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality*; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000401:mortality; D008297:Male; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D012189:Retrospective Studies; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology