Non-immune hydrops fetalis: prenatal diagnosis and perinatal outcomes.

Purpose: To describe the perinatal outcomes after a prenatal diagnosis of non-immune hydrops fetalis (NIHF).

Methods: Retrospective case series. University of Mississippi ultrasound database from July 2000 to January 2003 was reviewed for cases of NIHF. Records abstracted for maternal demographics and neonatal outcomes.

Results: Thirty-one cases of NIHF were identified and full data was available for 29 cases. Median gestational age at diagnosis was 17.3 weeks. Structural fetal malformations were noted in 22 cases (76%); most common were cystic hygroma (N = 17, 59%), followed by cardiac (N = 10, 34%). Amniocentesis was performed in 20 cases and 10 were aneuploid. Only 10 fetuses (34%) were liveborn and only five (17%) survived the neonatal period.

Conclusions: Antepartum diagnosis of NIHF conveys a grave perinatal prognosis. Associated anomalies can be expected in approximately 75% of cases. Even for those fetuses achieving viability, survival beyond the neonatal period is rare.