Retrospective analysis of 17 liveborn neonates with hydrops fetalis

Background: Hydrops fetalis (HF) is a condition with a high mortality rate. The cause may be due to a variety of underlying diseases. In the majority of cases, death occurs antepartum and intrapartum. For those that are born alive, it is difficult to survive. The purpose of this study was to analyze the clinical manifestations, etiologies and outcomes of liveborn babies with hydrops fetalis. Methods: From October 1995 through May 2001, 17 liveborn neonates that presented with HF were admitted to our neonate intensive care unit (NICU). We were retrospectively reviewed their records. Clinical data including gestational age (GA) at diagnosis and birth, birth weight, Apgar score, maternal and fetal presentations, laboratory data, etiology and outcome were retrospectively collected and analyzed. Results: The mean GA at diagnosis was 30.5 weeks and the mean GA at birth was 33.8 weeks. The male to female ratio was 8:9. Most cases presented with ascites (12/17) and cardiomegaly (8/17). The most common problem faced by the liveborn HF neonates was cardiovascular anomalies (7/17). Seven of these liveborn HF neonates survived. The overall mortality rate of HF in this review was 59%. In comparison with survival cases, those that died were diagnosed earlier, had lower Apgar scores, had more severe acidosis, and had pericardial effusion. Conclusion: Recent advances in prenatal ultrasonographic examinations have made early detection of fetal hydrops possible. The mortality rate of these liveborn hydropic neonates without receiving prenatal therapy was high. More effort in prenatal intervention is needed in order to decrease the mortality rate and improve the outcome of neonates with HF.