ORIGINAL ARTICLE Nonimmune Hydrops Fetalis: Factors Which Predict Outcome Manisha Kumar 1 • Vandana Jha 1 • Anuradha Singh 1 Received: 21 February 2017 / Accepted: 16 May 2017 / Published online: 2 June 2017 Ó Federation of Obstetric & Gynecological Societies of India 2017 About the Author Abstract Aims and Objective To evaluate the cause of NIHF cases referred to a tertiary referral center and to analyze the outcome. Materials and Methods A total of 130 cases of fetal hydrops registered during eight-year study period were reviewed. Antenatal ultrasound, blood investigations and postnatal fetal examination were done, and outcome was noted. Results Out of 130 cases of NIHF, antenatal ultrasound showed the presence of structural malformations in 94/130 (72.3%), cardiac abnormality was the most common (34/ 130, 26.1%) and cystic hygroma was seen in 15/130 (11.5%). Chromosomal abnormality was observed in 15(11.5%) cases, and Doppler US showed anemia in 4/130 (3.1%) cases only. Live born were 25 (12.9%), and rest all were stillborn or abortion. Later mean gestational age of presentation (p = 0.0001), presence of gastrointestinal malformation (p = 0.0001) and absence of structural malformations (p = 0.0441) were factors significantly associated with live birth; the presence of cystic hygroma (p = 0.0431) or structural heart defect (p = 0.007) was significantly associated with poor outcome. Conclusion Fetal anemia was not a common cause of NIHF in the study population. The early onset of hydrops and Manisha Kumar is a Professor in Department of Obstetrics & Gynaecology, Lady Hardinge Medical College, New Delhi, India; Vandana Jha is a Senior Resident, Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India; Anuradha Singh is an Associate Professor, Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India. & Manisha Kumar [email protected]1 Professor, Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, Bhagat Singh Marg, New Delhi 110001, India Dr Manisha Kumar is Professor (OBGYN) and Incharge of fetal medicine at Lady Hardinge Medical College, New Delhi. She has undergone training in genetics and fellowship from AIIMS, New Delhi, as part of FOGSI fetal medicine award, 2011. She received Corion award—FOGSI (2013)—for research paper ‘‘Post natal outcome of congenital anomalies in Low resource setting.’’ She has done pioneering work as principal investigator of first trimester screening for preeclampsia and other adverse pregnancy outcome through research project funded by ICMR. She has worked on the construction of first trimester reference centile chart of fetal biometry in Indian population (J Matern Fetal Neonatal Med. 2016 Nov 21:1–25). Her other areas of interest are antenatal ultrasound, fetal autopsy and genetic counseling, and she is working on WHO— SEARO project on stillbirth. The Journal of Obstetrics and Gynecology of India (May–June 2018) 68(3):197–203 https://doi.org/10.1007/s13224-017-1011-6 123
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Nonimmune Hydrops Fetalis: Factors Which Predict Outcome · cases of hydrops fetalis, 10 were lost to follow-up. Of 137 cases, 7 (10.4%) had immune hydrops and 130 cases had nonimmune
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ORIGINAL ARTICLE
Nonimmune Hydrops Fetalis: Factors Which Predict Outcome
Manisha Kumar1 • Vandana Jha1 • Anuradha Singh1
Received: 21 February 2017 / Accepted: 16 May 2017 / Published online: 2 June 2017
� Federation of Obstetric & Gynecological Societies of India 2017
About the Author
Abstract
Aims and Objective To evaluate the cause of NIHF cases
referred to a tertiary referral center and to analyze the
outcome.
Materials and Methods A total of 130 cases of fetal hydrops
registered during eight-year study period were reviewed.
Antenatal ultrasound, blood investigations and postnatal fetal
examination were done, and outcome was noted.
Results Out of 130 cases of NIHF, antenatal ultrasound
showed the presence of structural malformations in 94/130
(72.3%), cardiac abnormality was the most common (34/
130, 26.1%) and cystic hygroma was seen in 15/130
(11.5%). Chromosomal abnormality was observed in
15(11.5%) cases, and Doppler US showed anemia in 4/130
(3.1%) cases only. Live born were 25 (12.9%), and rest all
were stillborn or abortion. Later mean gestational age of
presentation (p = 0.0001), presence of gastrointestinal
malformation (p = 0.0001) and absence of structural
malformations (p = 0.0441) were factors significantly
associated with live birth; the presence of cystic hygroma
(p = 0.0431) or structural heart defect (p = 0.007) was
significantly associated with poor outcome.
Conclusion Fetal anemia was not a common cause of NIHF
in the study population. The early onset of hydrops and
Manisha Kumar is a Professor in Department of Obstetrics &
Gynaecology, Lady Hardinge Medical College, New Delhi, India;
Vandana Jha is a Senior Resident, Department of Obstetrics and
Gynaecology, Lady Hardinge Medical College, New Delhi, India;
Anuradha Singh is an Associate Professor, Department of Obstetrics
and Gynaecology, Lady Hardinge Medical College, New Delhi, India.