Prevalence and Etiologies of Hydrops Fetalis: 9 years period in King Chulalongkorn Memorial Hospital
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Abstract
Objectives: To assess the prevalence and etiologies of hydrops fetalis in King Chulalongkorn Memorial Hospital (KCMH) during a 9-year period.
Materials and Methods: A retrospective descriptive study was conducted. Medical records and laboratory investigations, such as ultrasonographic findings, placental pathology, and autopsy of singleton pregnant women diagnosed with hydrops fetalis (HF) at all gestational ages who delivered at KCMH between January 1, 2009, and December 31, 2017, were reviewed. Patients’ clinical characteristics and results of all investigations were evaluated and analyzed.
Results: 147 cases of hydrops fetalis were diagnosed out of 46,858 total deliveries at KCMH between 2009 and 2017 (0.31%). Immune HF occurred in 2 cases (1.4%), whereas non-immune HF (NIHF) occurred in 145 cases (98.6%). Among the two cases of immune HF, the cause was Rhesus blood group incompatibility. Regarding the 145 cases of NIHF, a cause was identified in 106 cases (73.1%), while the cause remained unidentified in 39 cases (26.9%). The most common cause of NIHF was hemoglobin Bart’s hydrops (24.1%), followed by chromosomal abnormalities (11.7%), lymphatic abnormalities (11.7%), and cardiovascular malformations (11%). Of the 147 cases, 40 (27.2%) were live births, but more than half died during the neonatal period, with only 15 (10.2%) surviving.
Conclusion: The prevalence of HF in KCMH between 2009 and 2017 was 0.31%. 98.6% were NIHF in which the most commonly known etiology was hemoglobin Bart’s hydrops.
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