COMPARISON OF ACTIVE AND EXPECTANT MANAGEMENT OF PREGNANT WOMEN WITH NON-IMMUNE FETAL HYDROPS


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Aim. To compare perinatal outcomes of women with non-immune hydrops fetalis undergoing active and expectant management. Materials and methods. The study comprised all pregnant women with non-immune fetal hydrops, who were managed at the V.I. Kulakov NMRC for OG&P from 2015 to 2020 (n=45). Group 1 (n=30) included pregnant women with non-immune fetal hydrops, who were examined antenatally according to the developed protocol, and some of them received intrauterine treatment (prospective group from 2018 to 2020). Group 2 included 15 pregnant women who received no antenatal examination and treatment (retrospective group from 2015 to 2018). Results. In group 1, the causes of non-immune hydrops fetalis were identified antenatally in 83.3% (25/30) of patients, and in more than a half of them (56.7%), pregnancy management was based on these findings. In group 2, causes of non-immune hydrops fetalis were identified antenatally in 60% (9/15) of patients, and they received no intrauterine treatment. Patients with an active management approach had higher rates of antenatal resolution of non-immune hydrops and higher perinatal survival rates; their newborns had higher Apgar scores and a lower need for resuscitation, mechanical ventilation, and cardiotonic agents. Conclusion. Antenatal identification of non-immune fetal hydrops causes helps guide active pregnancy management, leading to improved perinatal outcomes.

Full Text

Restricted Access

About the authors

Faina Z. Kadyrberdieva

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: f_kadyrberdieva@oparina4.ru
Ph.D. Student 117997, Russia, Moscow, Ac. Oparina str., 4

Roman G. Shmakov

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: r_shmakov@oparina4.ru
Dr. Med. Sci., Professor of the RAS, Director of the Institute of Obstetrics 117997, Russia, Moscow, Ac. Oparina str., 4

Ekaterina L. Bockeria

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_bokeriya@oparina4.ru
Dr. Med. Sci., Professor, Head of the 2nd Department of Pathology of Newborns and Premature Babies; Professor at the Department of Neonatology 117997, Russia, Moscow, Ac. Oparina str., 4

Kirill V. Kostyukov

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: k_kostyukov@oparina4.ru
Ph.D., Diagnostic Medical Sonographer at the Functional and Ultrasound Diagnostics 117997, Russia, Moscow, Ac. Oparina str., 4

Nana K. Tetruashvili

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: n_tetruashvili@oparina4.ru
Dr. Med. Sci., Head of the 2nd Obstetrics Department of Pathology of Pregnancy 117997, Russia, Moscow, Ac. Oparina str., 4

References

  1. Sileo F.G., Kulkarni A., Branescu I., Homfray T., Dempsey E., Mansour S. et al. Non-immune fetal hydrops: etiology and outcome according to gestational age at diagnosis. Ultrasound Obstet. Gynecol. 2020; 56(3): 416-21. https://dx.doi. org/10.1002/uog.22019.
  2. Huang H., Tsay P.K., Chiang M.C., Lien R., Chou Y.H. Prognostic factors and clinical features in liveborn neonates with hydrops fetalis. Am. J. Perinatol. 2007; 24(1): 33-8. https://dx.doi.org/10.1055/s-2006-958158.
  3. Ota S., Sahara J., Mabuchi A., Yamamoto R., Ishii K., Mitsuda N. Perinatal and one-year outcomes of non-immune hydrops fetalis by etiology and age at diagnosis. J. Obstet. Gynecol. Res. 2016; 42(4): 385-91. https://dx.doi. org/10.1111/jog.12922.
  4. Norton M.E., Chauhan S.P, Dashe J.S. Society for Maternal-Fetal Medicine (SMFM). Society for maternal-fetal medicine (SMFM) clinical guideline#7: nonimmune hydrops fetalis. Am. J. Obstet. Gynecol. 2015; 212(2): 127-39. https://dx.doi.org/10.1016/j.ajog.2014.12.018.
  5. Bellini C., Hennekam R.C.M. Non-immune hydrops fetalis: a short review of etiology and pathophysiology. Am. J. Med. Genet. 2012; 158A(3): 597-605. https://dx.doi.org/10.1002/ajmg.a.34438.
  6. Santo S., Mansour S., Thilaganathan B., Homfray T., Papageorghiou A., Calvert S. et al. Prenatal diagnosis of non-immune hydrops fetalis: what do we tell the parents? Prenat. Diagn. 2011; 31(2): 186-95. https://dx.doi.org/10.1002/ pd.2677.
  7. Bellini C., Donarini G., Paladini D., Calevo M.G., Bellini T., Ramenghi L.A. et al. Etiology of non-immune hydrops fetalis: an update. Am. J. Med. Genet. A. 2015; 167A(5): 1082-8. https://dx.doi.org/10.1002/ajmg.a.36988.
  8. Abrams M., Meredith K., Kinnard P., Clark R. Hydrops fetalis: a retrospective review of cases reported to a large national database and identification of risk factors associated with death. Pediatrics. 2007; 120(1): 84-9. https://dx.doi. org/10.1542/peds.2006-3680.
  9. Кадырбердиева Ф.З., Шмаков Р.Г., Бокерия Е.Л., Тетруашвили Н.К., Костюков К.В. Эффективность применения алгоритма обследования на антенатальном этапе при неиммунной водянке плода. Акушерство и гинекология. 2020; 7: 71-8.
  10. Abbasi N., Ryan G. Fetal primary pleural effusions: prenatal diagnosis and management. Best Pract. Res. Clin. Obstet. Gynecol. 2019; 58: 66-77. https:// dx.doi.org/10.1016/ j.bp.obgyn.2019.01.005.
  11. Berger V.K., Sparks T.N., Jelin A.C., Derderian C., Jeanty C., Gosnell K. et al. Non-immune hydrops fetalis. Do placentomegaly and polyhydramnios matter? J. Ultrasound Med. 2018; 37(5): 1185-91. https://dx.doi.org/10.1002/ jum.14462.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2021 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies