A Retrospective Analysis of Cases of Non-Immune Hydrops Fetalis in A Tertiary Center

INTRODUCTION: Non-immune hydrops fetalis (NIHF) can occur at different gestational ages and with different etiologies. The aim of this study was to investigate the association of gestational age at diagnosis and a novel clinical scoring system with survival in NIHF cases
METHODS: This retrospective study was conducted between January 2020 and January 2023 in the perinatology clinic of a tertiary care center. Maternal characteristics, causes of NIHF, and survival rate were analyzed. The hydrops score was calculated and compared for those less than and greater than 20 weeks.
RESULTS: Of 41 NIHF, etiology was determined in 76% (87% <20 weeks vs. 70% ≥20 weeks), including cardiovascular malformations (27%), cystic hygromas (17%), and chromosomal defects (12%). Cystic hygromas were more common before 20 weeks. Cardiac malformations were the most common cause after 20 weeks. There was a negative correlation between live birth and hydrops score. The overall survival was 7.3%. The most favorable overall survival is in NIHF cases associated with fetal arrhythmias and placental pathology for the second and third trimesters, respectively.
DISCUSSION AND CONCLUSION: Earlier gestational age at diagnosis and higher hydrops score are associated with lower survival rates in NIHF cases. Determining the cause, accompanying structural abnormalities, and the week NIHF is diagnosed will help predict prognosis and apply treatments earlier to improve care for these fetuses and newborns