Ultrasonographic severity scoring of non-immune hydrops: a predictor of perinatal mortality.
OBJECTIVE
To develop an ultrasonographic severity scoring of non-immune hydrops in order to predict perinatal outcomes in women with non-immune hydrops.


METHODS
The study population consisted of pregnant women who were admitted and delivered with the diagnosis of fetal non-immune hydrops and singleton gestation. Cases were divided into "perinatal survivor" and "perinatal non-survivor" groups. Perinatal non-survivor cases were defined as those with stillbirth or neonatal death ≤28 completed days after birth. The presence of an abnormal fluid collection in each body compartment, such as subcutaneous edema, pleural effusion, pericardial effusion, or ascites was assigned a score of 1 point per each body compartment, and the absence of abnormal fluid collection was scored as 0 point. The total number of abnormal fluid collections was converted to a numeric score, which was called the ultrasonographic severity scoring of non-immune hydrops (USNIH).


RESULTS
Perinatal death occurred in 46.5% (20/43) of the cases of non-immune hydrops. USNIH in patients of the non-survivor group was significantly higher than that in those of the survivor group [non-survivor group 3 (2-4) vs. survivor 2 (2-3); median (range); P<0.05]. Perinatal mortality rates were higher in patients with USNIH ≥3 points than in those with USNIH of 2 points (67% vs. 13%, P<0.005). This difference remained significant after adjustment for confounding variables. When confining analysis to those with idiopathic non-immune hydrops, women in the perinatal non-survivor group had significantly higher USNIH score than those in the perinatal survivor group, and this difference remained significant after adjustment.


CONCLUSIONS
Our USNIH system may be a reliable predictive marker for perinatal outcomes in cases of non-immune hydrops, especially in idiopathic hydrops during the antenatal period.
Su Ah
SA
Kim
Seung Mi
SM
Lee
Joon-Seok
JS
Hong
JoonHo
J
Lee
Chan-Wook
CW
Park
Byoung Jae
BJ
Kim
Kyo Hoon
KH
Park
Joong Shin
JS
Park
Jong Kwan
JK
Jun
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality; D007231:Infant, Newborn; D054238:Perinatal Mortality; D011247:Pregnancy; D056910:Republic of Korea / Q000453:epidemiology; D012720:Severity of Illness Index; D016216:Ultrasonography, Prenatal