P23.03: Preeclampsia due to fetal nonimmune hydrops: mirror syndrome and review of literature

Abstract

Introduction: diagnostic imaging, fetal monitoring are used in the care of pregnancy. Ultrasound use doubled, even 4/5 per pregnancy. Electronic fetal monitoring, during delivery has increased. 2/3 of perinatal deaths are, ante partum stillbirths. Lack of antenatal care is a major problem in developing countries. Antenatal screening have changed over the years. Clinicians advocate routine ultrasound screening, not known whether detection of these conditions through screening leads to improved perinatal outcome. Objective: To analyze stillbirths in our part of India, during 1998-2007 using RECODE analysis & study the Impact of failed antenatal care, presenting as unbooked delivery. Material and Methods: Outcome of deliveries in two centers in south India was retrospectively evaluated. Both centres are equipped with in-house obstetric and paediatric units. All cases are evaluated using a structured proforma, maternal age, birth order, birth weight, and consanguinity were documented. Maternal illness during pregnancy, intra partum complications, and ultrasound findings were noted congenital anomaly if detected, the type of follow-up given to the pregnant women, was noted. Postmortem analysis, the gold standard for diagnosis of internal anomalies was offered to the couple however no one consented. Observations: Results were grouped as booked births (B), unbooked births (UB). In B, stillbirths are 8/1000, in UB,100.7/1000. Women below 20 years/above 35 yrs were at higher risk in both groups. Recode analysis showed uterine maternal causes in UB, unclassified in Bgr. Conclusion: Stillbirth rate in India 26/1000. Reproductive health improved over the millennium, has reduced UB deliveries.

Exome Sequencing for Prenatal Diagnosis in Nonimmune Hydrops Fetalis

“…In nonimmune hydrops fetalis (NIHF), a disorder that affects 1 in 1700 to 3000 pregnancies, fluid overload develops in the fetus and there is a high risk of stillbirth, preterm birth, and neonatal complications or death. [8][9][10][11] Pregnant women with fetuses that have NIHF are also at risk for complications resulting from a form of preeclampsia called mirror syndrome. 8,9 NIHF is a shared, severe presentation of many genetic disorders.…”

“…[8][9][10][11] Pregnant women with fetuses that have NIHF are also at risk for complications resulting from a form of preeclampsia called mirror syndrome. 8,9 NIHF is a shared, severe presentation of many genetic disorders. Standard genetic testing with karyotyping or chromosomal microarray analysis identifies the cause of only 25% of NIHF cases and does not detect single-gene disorders.…”