Outcomes of Infants with Nonimmune Hydrops Fetalis Born after 22 Weeks' Gestation — Our Experience between 1982 and 2000

BackgroundThe prognoses of the majority of infants with nonimmune hydrops fetalis (NIHF) remain poor. We retrospectively investigated our previous cases of NIHF to obtain perspectives for treatment of future NIHF.Materials and MethodsThe medical records of 101 cases of mothers and NIHF infants delivered after 22 weeks' gestation in our center between 1982 and 2000 were investigated.ResultsThe overall perinatal mortality of NIHF was 65.9%. There were 16 intrauterine fetal deaths and 49 early neonatal deaths (within 28 days after delivery) among the 101 cases. The poor mortality rate was attributed to structural anomaly (mortality, 66.7%), congenital structural heart disease without arrhythmia (mortality, 86.7%), twin-to-twin transfusion syndrome (mortality, 80.0%) and cystic hygroma (mortality, 91.9%). There were significant differences between survival and early neonatal death for gestational age at referral, gestational age at delivery, birth weight, and Apgar scores at 1 and 5 minutes (p < 0.05). As the number of extravascular compartments with fluid accumulation increased, the neonatal prognosis became poorer.ConclusionThe outcome of NIHF correlated with the causal diseases. Earlier intrauterine intervention than occurred among the women and fetuses in this study may facilitate better prognoses for NIHF