Perinatal and one-year outcomes of non-immune hydrops fetalis by etiology and age at diagnosis
Perinatal and one-year outcomes of non-immune hydrops fetalis by etiology and age at diagnosis
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DOI：
10.1111/jog.12922
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发表时间：
2016-04-01
影响因子：
1.6
通讯作者：
Mitsuda, Nobuaki
中科院分区：
文献类型：
--
作者：
Ota, Shiyo;Sahara, Jun;Mitsuda, Nobuaki
目的尽管围产期保健取得了进展，但非免疫性胎儿水肿（NIHF）的预后仍然很差。我们已经检查了围产期和1年的NIHF在诊断时的孕龄和潜在病因的结果，以确定mortality.MethodsA的预测因子进行了回顾性分析，92妊娠与NIHF管理在医院之间的2000年和2012年。诊断时的孕龄，病因，围产期结局，和1年的结果进行了记录，和他们的协会assessed.ResultsA共41的92例（45%）导致胎儿死亡，33例（36%）存活到1年，但只有15的33名幸存者发育完整。非整倍体是NIHF最常见的原因（27%; 25/92）。在22周前确诊的34例患者中，29例胎儿（85%）死亡，4例（12%）存活至1年，无发育迟缓。同时，在30周后确诊的26例患者中，18例（69%）存活至1年。在这18人中，7人（27%）发育完整。大约一半的心脏异常妊娠（8/13）导致宫内胎儿死亡（IUFD）或早期新生儿死亡。非整倍体与高频率的IUFD，其余5个存活的新生儿，3个发育迟缓。结论NIHF的预后不同，根据潜在的病因和诊断时的胎龄。妊娠早期诊断NIHF与不良结局相关。了解主要病因对咨询和治疗很重要。
AimThe prognosis for non-immune hydrops fetalis (NIHF) is still poor despite progress in perinatal care. We have examined perinatal and 1-year outcomes for NIHF in relation to gestational age at diagnosis and underlying etiology in order to identify predictors of mortality.MethodsA retrospective review was conducted of 92 pregnancies with NIHF managed in hospital between 2000 and 2012. The gestational age at diagnosis, etiology, perinatal outcome, and 1-year outcome were recorded, and their associations assessed.ResultsA total of 41 of 92 cases (45%) resulted in fetal death, 33 patients (36%) survived to 1 year, but only 15 of the 33 survivors were developmentally intact. Aneuploidy was the most common cause of NIHF (27%; 25/92). Of the 34 patients who were diagnosed before 22 weeks, 29 fetuses (85%) died, and four (12%) survived to 1 year without developmental delay. Meanwhile, of the 26 patients diagnosed after 30 weeks, 18 (69%) survived to 1 year. Of those 18, seven (27%) were developmentally intact. Approximately half of the pregnancies with cardiac anomalies (8/13) resulted in intrauterine fetal death (IUFD) or early neonatal death. Aneuploidy was associated with a high frequency of IUFD, and of the remaining five surviving newborns, three had developmental delay.ConclusionThe prognosis for NIHF differs according to underlying etiology and gestational age at diagnosis. NIHF diagnosed early in gestation is associated with poor outcome. Knowledge of the primary etiology is important for counseling and therapy.