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Outcomes following antenatal identification of hydrops fetalis: a single-centre experience from 2001 to 2012
  1. Damien M Gilby1,
  2. J Bridie Mee2,
  3. C Omar Farouk Kamlin1,3,
  4. Louise H Kornman2,4,
  5. Peter G Davis1,3,4,
  6. Brett James Manley1,3,4
  1. 1Newborn Research Centre and Neonatal Services, The Royal Women’s Hospital, Parkville, Melbourne, Victoria, Australia
  2. 2Department of Obstetrics and Gynaecology, The Royal Women’s Hospital, Parkville, Melbourne, Victoria, Australia
  3. 3Murdoch Children’s Research Institute, Parkville, Melbourne, Victoria, Australia
  4. 4Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Dr Damien M Gilby, Newborn Research Centre and Neonatal Services, The Royal Women’s Hospital, Parkville, Melbourne, VIC 3052, Australia; damiengilby{at}gmail.com

Abstract

Objective To describe the aetiologies and outcomes of pregnancies complicated by hydrops fetalis (HF).

Study design Case series of all pregnancies complicated by HF managed at The Royal Women’s Hospital (RWH), Melbourne, Australia, between 2001 and 2012. Multiple pregnancies, and cases where antenatal care was not provided at RWH were excluded. Cases were identified from neonatal and obstetric databases. Data were extracted from maternal and neonatal case files, electronic pathology and radiology reports, and obstetric and neonatal databases.

Results Over 12 years, 131 fetuses with HF with a median (IQR) gestational age (GA) at diagnosis of 24 (20–30) weeks were included in the analysis. There were 65 liveborn infants with a median (IQR) GA at birth of 33 (31–37) weeks and a median (IQR) birthweight Z-score of 1.4 (0.4–2.2). Overall survival from diagnosis was 27% (36/131) increasing to 55% (36/65) if born alive.

Conclusions The perinatal mortality risk for fetuses and newborn infants with HF is high with important differences dependent on underlying diagnosis and the time at which counselling is provided. Clinicians need to be aware of the outcomes of both fetuses and neonates with this condition.

  • hydrops fetalis
  • fetus
  • newborn
  • congenital anomaly

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Footnotes

  • Contributors DMG was involved in study design, data collection, statistical analysis and first draft of the manuscript. JBM was involved in the study design, data collection, identification of cases and editing the manuscript. COFK was involved in the study design, data analysis and production of the manuscript. LHK was involved in study design, analysis of ultrasound images where there was any doubt about diagnosis along with editing the manuscript. PGD had a primary role in supervising the study design and data analysis along with editing the manuscript. JBM had a role in study design, data analysis and primary role in revision of the manuscript. All authors contributed in part to the final manuscript.

  • Funding The work was supported by a National Health and Medical Research Council (NHMRC) Program grant number 384100.

  • Competing interests COFK and JBM are recipients of NHMRC Early Career Fellowships Scholarships and PGD is a recipient of an NHMRC Practitioner Fellowship.

  • Patient consent Not required.

  • Ethics approval This study was approved by the RWH Research and Ethics Committee as an audit of practice.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data tables are retained by Damien Gilby and includes some limited additional data on treatments required by infants admitted to the NICU.

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