Non-immune hydrops: Qatar experience

Objective: To describe the presenting signs, diagnostic findings, and outcomes of 64 cases of non-immune hydrops fetalis (NIHF) cases seen in Women's Hospital, Qatar during the years 2003-2011. Method: A retrospective chart review of patients with signs suggesting of NIHF was done. A detailed scan was performed and karyotyping and detailed investigations were offered. Results: Average maternal age at diagnosis was 31 years. Fifty-six percent of the patients were diagnosed during the 2nd trimester. Most common presenting signs were: ascites, pleural effusion, scalp edema, skin edema, pericardial effusion, generalize edema and cystic hygroma. Two patients were positive for PV B19 infection. Fetal karyotyping performed in 78% of the patients showed abnormal chromosomes in 9 cases. Three patients showed fetal anemia with abnormal peak systolic velocity of the medial cerebral artery (MCA-PSV). Seventeen (27%) fetuses survived the perinatal period with live births occurring between gestational ages 30-41 weeks. Ten (59%) of the 17 babies survived post delivery (6 months post survival data). Major identifiable abnormalities that might have caused symptoms of hydrops were cardiac (23.43%), and chromosomal (14%). Conclusion: Non-immune hydrops fetalis is a complex problem. Establishment of a clear procedure for the follow up of such patients is extremely important.