Outcome and Treatment of Antenatally Diagnosed Nonimmune Hydrops Fetalis

Ahmed A. Nassr, Amen Ness, Pardis Hosseinzadeh, Bahram Salmanian, Jimmy Espinoza, Victoria Berger, Eleonore Werner, Hadi Erfani, Stephen Welty, Zhoobin H. Bateni, Amir A. Shamshirsaz, Edwina Popek, Rodrigo Ruano, Alexis S. Davis, Timothy C. Lee, Sundeep Keswani, Darrell L. Cass, Oluyinka O. Olutoye, Michael A. Belfort, Alireza A. Shamshirsaz

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Introduction: The objectives of this study were to evaluate the outcome of nonimmune hydrops fetalis in an attempt to identify independent predictors of perinatal mortality. Material and Methods: A retrospective cohort study was conducted including all cases of nonimmune hydrops from two tertiary care centers. Perinatal outcome was evaluated after classifying nonimmune hydrops into ten etiological groups. We examined the effect of etiology, site of fluid accumulation, and gestational age at delivery on postnatal survival. Neonatal mortality and hospital discharge survival were compared between the expectant management and fetal intervention groups among those with idiopathic etiology. Results: A total of 142 subjects were available for analysis. Generally, nonimmune hydrops carried 37% risk of neonatal mortality and 50% chance of survival to discharge, which varies markedly based on the underlying etiology. Ascites was an independent predictor of perinatal mortality (p value = 0.003). There was nonsignificant difference in neonatal mortality and hospital discharge survival among idiopathic cases that were managed expectantly versus those in whom fetal intervention was carried out. Discussion: The outcome of nonimmune hydrops varies largely according to the underlying etiology and the presence of ascites is an independent risk factor for perinatal mortality. In our series, fetal intervention did not offer survival advantage among fetuses with idiopathic nonimmune hydrops.

Original languageEnglish (US)
Pages (from-to)123-128
Number of pages6
JournalFetal Diagnosis and Therapy
Volume43
Issue number2
DOIs
StatePublished - Feb 1 2018
Externally publishedYes

Keywords

  • Fetal ascites
  • Fetal hydrops
  • Fetal intervention
  • Fetal pleural effusion
  • Neonatal mortality
  • Perinatal mortality
  • Survival

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

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    Nassr, A. A., Ness, A., Hosseinzadeh, P., Salmanian, B., Espinoza, J., Berger, V., Werner, E., Erfani, H., Welty, S., Bateni, Z. H., Shamshirsaz, A. A., Popek, E., Ruano, R., Davis, A. S., Lee, T. C., Keswani, S., Cass, D. L., Olutoye, O. O., Belfort, M. A., & Shamshirsaz, A. A. (2018). Outcome and Treatment of Antenatally Diagnosed Nonimmune Hydrops Fetalis. Fetal Diagnosis and Therapy, 43(2), 123-128. https://doi.org/10.1159/000475990