The effectiveness of the antenatal examination algorithm for nonimmune hydrops fetalis

Objective. To evaluate the effectiveness of the antenatal examination algorithm for nonimmune hydrops fetalis. Materials and methods. The study included pregnant women with nonimmune hydrops fetalis delivered at the Center from 2015 to 2020 (n=45), and divided into two groups. Group 1 (prospective group from 2018 to 2020) included 30 pregnant women with nonimmune hydrops fetalis who were antenatally examined and, in some cases, received intrauterine treatment; group 2 (retrospective group from 2015 to 2018) consisted of 15 women who were not antenatally examined and did not receive intrauterine treatment. Pregnant women were selected by the perinatal council of the Center. Results. According to the examination protocol, in group 1 the etiology of nonimmune hydrops fetalis was antenatally determined in 83.3% (25/30) of cases and 16.7% (5/30) of cases were considered as idiopathic. In group 2 the etiology was established in 86.7% (13/15) of cases: it was determined in 60% (9/15) of cases antenatally (on the basis of fetal ultrasound), and in 26.7% (4/15) of cases postnatally. The live birth rate did not differ statistically between groups, namely 70% (21/30) in group 1 versus 73.3% (11/15) in group 2 (p=0.94). However, the neonatal mortality rate was statistically higher in the group where intrauterine treatment was not performed, namely 73.8% (8/11) versus 23.8% (5/21) (p=0.002). Thus, the overall survival in group 1 was 53.3% (16/30), while in group 2 it was 20% (3/15). Conclusion. The introduction of the examination protocol into clinical practice has led to an increase in the detection of the causes of nonimmune hydrops fetalis at the antenatal stage, especially in the cases not associated with fetal malformations.

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