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Abstract
Fifty pregnancies complicated by fetal ascites and generalized edema are reviewed
and their prenatal findings, obstetric management, and fetal outcome are discussed.
From the myriad of maternal, fetal, and placental problems which are known to cause
nonimmune hydrops fetalis, many different causes of the disorder could be identified
in 84% of all patients studied by extensive prenatal and postnatal workup. Therefore,
in only 16% of the cases was the nonimmune hydrops fetalis labeled “idiopathic.” The
most common demonstrable causes of the disorder in this series were cardiac anomalies,
followed by chromosomal disorders, congenital malformations, α-thalassemia, and the
twin-twin transfusion syndrome. A systematic approach to the prenatal diagnostic workup
of nonimmune hydrops fetalis is outlined, starting with the least invasive techniques
(ultrasound, echocardiography, complete blood count, Kleihauer-Betke analysis, TORCH
testing, and so forth) followed by more invasive techniques (amniocentesis and fetoscopy).
Although the detection and prognostic evaluation of nonimmune hydrops fetalis are
greatly improved by applying these techniques, the overall prognosis for most fetuses
with nonimmune hydrops fetalis is still very poor, and only a few conditions causing
the disorder, such as prenatally detected cardiac arrhythmias or selected cases of
urinary tract obstruction, are amenable to treatment in utero.
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Article Info
Publication History
Accepted:
June 7,
1984
Received:
November 10,
1983
Identification
Copyright
© 1984 Published by Elsevier Inc.
