ANTENATAL SONOGRAPHIC FEATURES OF 100 ALPHA-THALASSEMIA HYDROPS-FETALIS FETUSES

Objective: To characterize the sonographic findings of alpha-thalassem ia hydrops fetalis. Methods: Descriptive study of the ultrasound findi ngs in 100 women with antenatal diagnosis of hydrops fetalis due to al pha-thalassemia. Results: Mean (+/-SD) maternal age was 27.5 + 5.7 yea rs (17-41 years). Mean menstrual age was 31.3 +/- 4.7 weeks (22-42 wee ks). All fetuses were stillborn or died very shortly after birth. The indications for sonographic examination included early onset of pre-ec lampsia, large for date, decreased fetal movement and nonreactive NST, or bradycardia and premature contractions. The sonographic features f ound in more than 90% of cases included hepatosplenomegaly, cardiac en largement, edematous placenta, and ascites. Other common findings were oligohydramnios (82%), subcutaneous edema (75%), decreased fetal move ment (74%), cord edema (63%), and enlarged umbilical vessel (62%). Per icardial or pleural effusion was seen in only 15% of cases. None of th e fetuses showed any morphological abnormality. Early findings (22-28 weeks) included evidence of a thickened placenta and/or minimal ascite s and/or slight cardiomegaly. Conclusions: The sonographic characteris tics of alpha-thalassemia hydrops fetalis ranged from no obvious morph ological abnormalities to evidence of fluid retention. These typical a bnormal findings generally did not appear until the late second trimes ter or early third trimester. (C) 1996 John Wiley & Sons, Inc.