SUCCESSFUL OUTCOME OF IDIOPATHIC NONIMMUNE HYDROPS-FETALIS TREATED BYMATERNAL DIGOXIN

Nonimmune hydrops fetalis (NIHF), occurring in 1 in 2,500-3,000 live b irths, has a reported mortality rate of 50-98%. A similar mortality ra te for intrauterine death of fetuses with NIHF probably exists. Many f etal pathological entities have been implicated as causing the conditi on, but to date, treatment has only been found for cases of fetal tach ycardia complicated with hydrops. During a routine ultrasonographic su rvey of a woman at 32 weeks of gestation, we detected a fetus with sev ere ascites. There was no apparent etiology, and although no tachycard ia was evident, low dosage transplacental digoxin therapy was immediat ely initiated. The hydropic condition completely resolved within 17 da ys, and at 39 weeks of gestation, a perfectly normal baby was born aft er a spontaneous and uneventful labor. This is the first report of suc cessful treatment of idiopathic NIHF with maternal digoxin.