PDF(1384 KB)
Clinical features and prognosis of neonates with nonimmune hydrops fetalis
LIU Hui, ZHANG Hua, TONG Xiao-Mei
Chinese Journal of Contemporary Pediatrics ›› 2019, Vol. 21 ›› Issue (3) : 253-258.
PDF(1384 KB)
PDF(1384 KB)
Clinical features and prognosis of neonates with nonimmune hydrops fetalis
Objective To study the clinical features, etiology and prognosis of neonates with nonimmune hydrops fetalis (NIHF). Methods A retrospective analysis was performed for the clinical data and outcomes of 23 neonates with NIHF. Results Of the 23 neonates with NIHF, 18 (78%) were preterm infants and 5 (22%) were full-term infants; 12 (52%) had birth asphyxia (including 5 cases of severe asphyxia). As for the causes of NIHF, 8 neonates (35%) had twintwin transfusion syndrome (TTTS), 3 (13%) had cardiovascular malformation, 3 (13%) had parvovirus B19 infection, 2 (9%) had congenital chylothorax, 1 (4%) had Turner syndrome, 1 (4%) had Coxsackie virus infection, and 5 (22%) had unknown etiology. Of the 23 neonates, 13 achieved clinical cure, 10 died, resulting in a neonatal mortality rate of 43%. Compared with the survival group, the death group had a signifcantly higher proportion of preterm infants or infants with asphyxia, 5-minute Apgar score <8 or heart failure (100%/100%/60%/60% vs 62%/15%/8%/8%; P < 0.05). Conclusions Birth asphyxia is common in neonates with NIHF. The neonates with a lower gestational age, a more serious asphyxia or heart failure have a higher risk of death in the neonatal period. Being the recipient of TTTS is a major cause of NIHF.
Nonimmune hydrops fetalis / Twin-twin transfusion syndrome / Asphyxia / Neonate
[1] Steurer MA, Peyvandi S, Baer RJ, et al. Epidemiology of live born infants with nonimmune hydrops fetalis-insights from a population-based dataset[J]. J Pediatr, 2017, 187:182-188.e3.
[2] Society for Maternal-Fetal Medicine (SMFM), Norton ME, Chauhan SP, et al. Society for maternal-fetal medicine (SMFM) clinical guideline #7:nonimmune hydrops fetalis[J]. Am J Obstet Gynecol, 2015, 212(2):127-139.
[3] Laterre M, Bernard P, Vikkula M, et al. Improved diagnosis in nonimmune hydrops fetalis using a standardized algorithm[J]. Prenat Diagn, 2018, 38(5):337-343.
[4] Bellini C, Hennekam RC, Fulcheri E, et al. Etiology of nonimmune hydrops fetalis:a systematic review[J]. Am J Med Genet A, 2009, 149A(5):844-851.
[5] 王学举, 于海燕, 魏瑗, 等. 33例非免疫性胎儿水肿患儿临床特点与妊娠结局[J]. 实用妇产科杂志, 2015, 31(10):748-752.
[6] Moreno CA, Kanazawa T, Barini R, et al. Non-immune hydrops fetalis:a prospective study of 53 cases[J]. Am J Med Genet A, 2013, 161A(12):3078-3086.
[7] Takci S, Gharibzadeh M, Yurdakok M, et al. Etiology and outcome of hydrops fetalis:report of 62 cases[J]. Pediatr Neonatol, 2014, 55(2):108-113.
[8] Yeom W, Paik ES, An JJ, et al. Clinical characteristics and perinatal outcome of fetal hydrops[J]. Obstet Gynecol Sci, 2015, 58(2):90-97.
[9] Ota S, Sahara J, Mabuchi A, et al. Perinatal and one-year outcomes of non-immune hydrops fetalis by etiology and age at diagnosis[J]. J Obstet Gynaecol Res, 2016, 42(4):385-391.
[10] Thong XY, Lee LY, Chia DA, et al. Management and outcomes of fetal hydrops in a tertiary care centre in singapore[J]. Ann Acad Med Singapore, 2017, 46(1):4-10.
[11] Gilby DM, Mee JB, Kamlin COF, et al. Outcomes following antenatal identification of hydrops fetalis:a single-centre experience from 2001 to 2012[J]. Arch Dis Child Fetal Neonatal Ed, 2018, pii:fetalneonatal-2017-313604.
[12] Nakayama A, Oshiro M, Yamada Y, et al. Prognostic factors of hydrops fetalis with pleural effusion[J]. Pediatr Int, 2017, 59(10):1053-1057.
[13] 蔡成, 龚小慧, 裘刚, 等. 非免疫性胎儿水肿10例临床分析[J]. 临床儿科杂志, 2017, 35(9):658-661.
[14] 林胜谋, 王晨虹, 朱小瑜, 等. 胎儿水肿156例临床分析[J]. 中华妇产科杂志, 2011, 46(12):905-910.
[15] Bialkowski A, Poets CF, Franz AR, et al. Congenital chylothorax:a prospective nationwide epidemiological study in Germany[J]. Arch Dis Child Fetal Neonatal Ed, 2015, 100(2):F169-F172.
[16] Fukushima K, Morokuma S, Fujita Y, et al. Short-term and longterm outcomes of 214 cases of non-immune hydrops fetalis[J]. Early Hum Dev, 2011, 87(8):571-575.
[17] Abrams ME, Meredith KS, Kinnard P, et al. Hydrops fetalis:a retrospective review of cases reported to a large national database and identification of risk factors associated with death[J]. Pediatrics, 2007, 120(1):84-89.
