Nonimmune hydrops fetalis: main causes

Objective. To determine the structure of the causes of nonimmune hydrops fetalis and to compare this with the data obtained by foreign authors. Subjects and methods. The investigation enrolled 80 pregnant women with nonimmune hydrops fetalis who had sought medical advice at the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology in January 2015 to March 2019. According to clinical signs and data from clinical, laboratory and instrumental studies, all the cases were divided into one of 14 categories of diseases leading to nonimmune hydrops fetalis. The results of this study were compared with data from large-scale foreign studies. Results. All cases of nonimmune hydrops fetalis in January 2015 to March 2019 were retrospectively analyzed. The etiology was established in 82.5% (66/80) of cases. The most common causes of nonimmune hydropsy fetalis were chromosomal abnormalities [20.0% (16/80)], cardiovascular disease [18.75% (15/80)], and infections [8.75% (7/80)]. Syndromic diseases, thoracic abnormalities, and extrathoracic tumors occurred with the same frequency [7.5% (6/80)]. Conclusion. In the presence of nonimmune hydrops fetalis, there is a need for a comprehensive diagnostic approach that requires a fetal ultrasound assessment by experts (by estimating the highest blood flow velocity in the middle cerebral artery), fetal echocardiography, as well as invasive diagnosis through amniocentesis in order to identify a fetal karyotype and infectious and inflammatory factors. In the early neonatal period, the newborn baby should be examined for metabolic diseases by tandem mass spectrometry.

pregnancy, nonimmune hydrops fetalis, ascites, hydrothorax, fetal malformations, aneuploidies