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HYDROPS FETALIS: ANTENATAL DIAGNOSIS AND POSTNATAL OUTCOMES
  1. C A Pitan1,
  2. E Molloy1,
  3. P McParland2,
  4. T O’Caroll1,
  5. M Thomas1
  1. 1Neonatal Unit, National Maternity Hospital, Dublin, Ireland
  2. 2Fetal Assessment Unit, National Maternity Hospital, Dublin, Ireland

Abstract

Aims We wished to determine the number of cases, aetiology, antenatal interventions, and postnatal outcomes of pregnancies complicated by hydrops fetalis at our hospital.

Methods All ultrasounds of patients attending the Fetal Assessment Unit from Jan 2001–Dec 2007 were reviewed. Maternal age and gestational age at diagnosis, antenatal investigations and interventions; mode of delivery and infant outcomes to hospital discharge were determined form the medical notes.

Results 37 cases were identified; the women aged 21–42 years and hydrops was diagnosed at 13–39 weeks. Aetiology was identified in 18 (50%); these included TORCH infections (4), immune hydrops (3), chromosomal anomalies (3), cardiac anomalies (3), cystic hygroma (3), chylothorax (2). 21 had antenatal procedures; all had blood tests, 7 had intrauterine transfusions, 6 had shunting/drainage, and 3 had amniocentesis. 13 patients were referred from other hospitals; they were subsequently discharged to the referring hospital and lost to follow-up. 24 delivered at NMH (18 vaginal deliveries and 6 caesarean sections). There were 2 spontaneous miscarriages, 9 intrauterine deaths and 13 were liveborn. Of the 13 liveborn infants, 4 died in the delivery room and 9 were admitted to NICU (length of hospital stay 5–46 days). Six infants survived until discharge.

Conclusions Fetal hydrops has a high antenatal and postnatal mortality (54% and 46% respectively). Antenatal diagnosis is helpful for planned management but did not predict survival. A well structured, targeted investigative approach yielded a prenatal diagnosis in nearly 50% of cases. These results are in keeping with similar international studies.

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