Objective We aimed to define the etiologic features, outcome of liveborn hydrops fetalis and identify predictors of mortality in a single tertiary unit over an 11-year period.
Method Medical records of liveborn neonates with hydrops fetalis between 2000–2011 were reviewed retrospectively. Demographic data, antenatal interventions clinical manifestations, laboratory findings, outcomes and complete or partial autopsy records were analyzed.
Results Twenty six live born cases of hydrops fetalis with a sex distribution of 33 males and 29 females from the 16,200 live born deliveries in our hospital; an incidence of 3.8/1000 live births. 28 infants (45%) were diagnosed as immune hydrops fetalis. Overall, 32 infants (50%) survived to discharge. The survival rates were comparable within the immune and nonimmune etiology (43% vs. 53%, p>0.05). Of the 34 nonimmune hydrops fetalis (NIHF) cases, a plausible cause could be found for 24 (70.5%). Post-mortem examinations were performed in 11 cases of 16 non-surviving infants with NIHF. The two factors that were associated independently with mortality in the stepwise multiple logistic regression analyses were a low 5 minute Apgar score and the need for surfactant treatment.
Conclusion Despite the improvements in postnatal care mortality rates are high and treatment options are still limited. The prenatal and postnatal procedures to improve lung capacity and function are necessary to achieve favorable outcome.