The perinatal mortality risk for fetuses and newborn infants with HF is high with important differences dependent on underlying diagnosis and the time at which counselling is provided. Clinicians need to be aware of the outcomes of both fetuses and neonates with this condition.
Background
Hydrops fetalis is a potentially lethal condition diagnosed on the basis of excess fluid accumulation in at least two potential spaces including ascites, pericardial effusion, pleural effusion, or skin. Data on the prognosis of this condition are limited.
Aim
To describe the outcomes of infants born with hydrops fetalis in a single centre over an 11 year period.
Method
We performed a retrospective case review of inborn neonates diagnosed with hydrops fetalis admitted to the neonatal unit (NICU) at The Royal Women’s Hospital between 2001 and 2012. Cases were identified through a search of neonatal and obstetric databases. Data were extracted from maternal and neonatal case files, along with electronic reports from pathology and radiology databases and the obstetric and neonatal databases.
Results
We identified 193 fetuses with hydrops continuing beyond 17 weeks gestation. The outcome of 151 pregnancies occurred at the Royal Women’s Hospital. 73 cases resulted in fetal death in utero or termination, in 23 cases the hydrops resolved antenatally and 52 infants were born alive with hydrops. The most common causes of hydrops were idiopathic (35%); cardiac (19%); non-cardiac anomaly (15%) and syndromal (12%). Of the 52 infants born alive, 20 (39%) survived to hospital discharge. Survival with idiopathic hydrops was 28%.
Conclusions
Overall survival in infants born alive with hydrops was 39%. Idiopathic hydrops was the most common diagnosis and had one of the poorest survival rates.
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