Non-immune Hydrops Fetalis: Retrospective Evaluation of Pathophysiological Mechanisms

Abstract

Objective: Nonimmune hydrops fetalis (NIHF) is associated with abnormal fluid collections in fetal soft tissues and serous cavities due to nonimmunologic causes. It should be considered as a symptom, rather than a disorder. We aimed to investigate etiology and pathophysiology in cases with NIHF during a four-year time period. Methods: Eleven live-born infants with NIHF were evaluated retrospectively. Demographic data, laboratory values, and results of specified tests were recorded. Etiology and pathophysiological mechanisms were established. Results: The mean gestational age at birth was 32.8±2.6 weeks and the mean birth weight was 2545±809 grams. All cases presented with edema and ascites. Chromosomal disorders (5/11) were the leading etiology. Pathophysiological mechanisms were observed as fetal hypotonia, fetal hypoxia, lymphatic disorders, hypoalbuminemia, early closure of ductus arteriosus, anemia, and right-sided heart failure. Mortality was 72%. Conclusion: In the presented study NIHF occurred as a symptom which was presented in various conditions based on different mechanisms. Evaluations made in infants with NIHF should aim both diagnosis of the condition as well as finding out the underlying pathophysiological mechanisms. Mortality rate in infants with NIHF is high even though the improvements in neonatal care.