• fetal medicine
• fetal hydrops
• nihf

The causes and outcomes of fetal hydrops have been well described in the literature over many years. Anti-D immunoglobulin has dramatically reduced the rate (and mortality) of immune hydrops such that non-immune hydrops (NIHF) now accounts for 90% of cases.1 Hydrops is a challenging condition to counsel for due to the relative rarity (1 in 1700–3000 pregnancies) and the fact it is the preterminal manifestation of many different pathophysiological processes.2–4

The paper published in our sister journal Fetal & Neonatal by Gilby et al 5 addresses two key questions that all expectant parents faced with this problem would ask: what is the cause of the hydrops and will my baby survive? Diagnosis in NIHF is of paramount importance to accurate counselling. The more refined the phenotype the more accurate information a clinician is able to provide on mortality, morbidity and treatment options.6 Gilby et al report that with ‘modern’ antenatal investigations, a diagnosis was achieved in 69% of cases while for those without a diagnosis but born alive, 43% were given a postnatal diagnosis. This confirms other recent …