Incidence, Ultrasonographic Findings, and Pregnancy Outcomes in Cases of Hydrops Fetalis at Thammasat University Hospital

Abstract

OBJECTIVE: To investigate the incidence, ultrasonographic findings, and pregnancy outcomes of hydrops fetalis at Thammasat University Hospital. MATERIALS AND METHODS: A retrospective study was conducted. Inclusion criteria required that all participants had gestational age (GA) confirmed by ultrasound for pregnancies of less than 20 weeks. RESULTS: In total, 171 pregnant women participated in this study, and 10 cases were excluded due to incomplete data. This study was conducted on 161 pregnant women for analysis. The mean GA at diagnosis was 23.4 ± 4.9 weeks. The most crucial etiology of hydrops fetalis was Hb Bart’s disease (41.6%). Other etiologies included chromosomal abnormalities (11.2%), structural abnormalities (5%), infections (3.1%), and hemoglobinopathies (non-Hb Bart’s disease) (2.5%). The percentage of etiologies that could not be identified was 36.6%. Most cases of Hb Bart’s disease were found after a GA of 20 weeks, as indicated by the ultrasound findings, and included conditions such as ascites and cardiomegaly. Further, 44.4% of the group with chromosomal abnormalities were found earlier than 20 weeks and had ascites and skin edema; trisomy 21 was the primary cause. Fifty percent of the structural abnormalities group were found before 20 weeks. Most infectious groups presented late compared to the others, and syphilis was the primary cause. CONCLUSIONS: The most common cause of hydrops fetalis was Hb Bart’s disease, followed by chromosomal abnormalities, structural abnormalities, and then infections. Ascites was the most common finding in all etiologies. However, in the group of ongoing pregnancies with negative investigations, there were good outcomes with viable newborns.