Clinical features and prognosis of neonates with nonimmune hydrops fetalis

Abstract:

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.