ETIOLOGY AND OUTCOME OF HYDROPS-FETALIS

Hydrops fetalis is a morbid condition caused by a wide variety of dise ases. Although treatment for some underlying pathologies is becoming a vailable, the prognosis remains poor. To analyze the etiology and outc ome of hydrops fetalis, we reviewed the records of 79 fetuses encounte red at the National Taiwan University Hospital between January 1993 an d October 1996. The mean +/- standard deviation gestational age at pre sentation was 2.49 +/- 6.3 weeks. One case was due to RhE incompatibil ity. Seventy-eight fetuses were diagnosed as having nonimmune hydrops fetalis; this was idiopathic in 20 fetuses. In the other 58, the cause s and associated conditions were classified into eight groups: hematol ogic (25), cardiovascular (15), chromosomal (5), gastrointestinal (4), cystic hygroma (3), pulmonary (2), infection (2), and miscellaneous ( 3). One fetus with cystic hygroma also had a chromosomal abnormality ( Turner's syndrome). The most common cause of nonimmune hydrops fetalis was homozygous alpha-thalassemia (31%). Twenty-nine fetuses were lost to follow-up after initial evaluation and 50 fetuses were delivered a t our hospital. Of these, there were eight cases of antepartum death, 24 cases of intrapartum death, and 18 live births. Seventeen of the li ve-born infants were treated at our neonatal intensive care unit, of w hom only seven survived.