Management of non-immune hydrops: 8 years' experience

Ultrasound Obstet Gynecol. 1996 Sep;8(3):196-200. doi: 10.1046/j.1469-0705.1996.08030196.x.

Abstract

During a period of 8 years (1985-92), 100 fetuses were diagnosed to have non-immune hydrops on the basis of ultrasonographic findings and absence of rhesus isoimmunization. Both the mother and the fetus were thoroughly evaluated by a set protocol that included a detailed fetal abnormality scan with echocardiography and fetal blood sampling. A cause for non-immune hydrops could be identified in 81% of the fetuses. Cardiovascular abnormalities (23%) and alpha(1)-thalassemia (22%) were almost equally common etiological factors in the South-East Asian population under investigation. A chromosomal abnormality was detected in 10% of the fetuses with non-immune hydrops. Twenty-six fetuses were found to be suitable for in utero therapy. In utero therapy included one or more of the following: (1) fetal intravascular blood transfusion; (2) direct fetal drug therapy; and (3) fetal pleuroamniotic shunting. Eighteen of the 26 babies (69.2%) were alive and well at 1 month after delivery. It is concluded that in well-selected cases appropriate in utero fetal therapy can lead to significant improvement in fetal salvage.

MeSH terms

  • Evaluation Studies as Topic
  • Female
  • Fetal Blood / immunology
  • Fetal Death
  • Fetal Diseases / diagnosis
  • Fetal Diseases / physiopathology
  • Fetal Diseases / therapy
  • Humans
  • Hydrops Fetalis / diagnosis
  • Hydrops Fetalis / physiopathology
  • Hydrops Fetalis / therapy*
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Outcome*
  • Prenatal Diagnosis / methods*
  • Prognosis
  • Ultrasonography, Prenatal