Nonimmune Hydrops Fetalis: Factors Which Predict Outcome

Abstract

Aims and Objective: To evaluate the cause of NIHF cases referred to a tertiary referral center and to analyze the outcome. Materials and Methods: A total of 130 cases of fetal hydrops registered during eight-year study period were reviewed. Antenatal ultrasound, blood investigations and postnatal fetal examination were done, and outcome was noted. Results: Out of 130 cases of NIHF, antenatal ultrasound showed the presence of structural malformations in 94/130 (72.3%), cardiac abnormality was the most common (34/130, 26.1%) and cystic hygroma was seen in 15/130 (11.5%). Chromosomal abnormality was observed in 15(11.5%) cases, and Doppler US showed anemia in 4/130 (3.1%) cases only. Live born were 25 (12.9%), and rest all were stillborn or abortion. Later mean gestational age of presentation (p = 0.0001), presence of gastrointestinal malformation (p = 0.0001) and absence of structural malformations (p = 0.0441) were factors significantly associated with live birth; the presence of cystic hygroma (p = 0.0431) or structural heart defect (p = 0.007) was significantly associated with poor outcome. Conclusion: Fetal anemia was not a common cause of NIHF in the study population. The early onset of hydrops and presence of structural malformation carry a graver prognosis; type of structural defect also has bearing on outcome.