Etiology and prognosis of non-immune hydrops fetalis: A literature review
DOI:
https://doi.org/10.33448/rsd-v13i10.47000Keywords:
Fetal dropsy, Fetal edema, Fetal hydrops.Abstract
Introduction: Hydrops Fetalis is defined as an abnormal accumulation of fluid in the fetal compartments. It is estimated that 1 in 1,700 to 3,000 pregnancies are affected by this pathology. It can be subdivided into isoimmune or non-immune. The non-immune cause corresponds to 90% of cases and has variable etiopathogenesis. The prognosis varies according to the etiology. Method: Literature review with searches in the PubMed and Scielo databases, according to the guiding question: "What is the etiological cause and prognosis of patients affected by non-immune Hydrops Fetalis?". Results and Discussion: Hydrops Fetalis is a rare condition with a high morbidity and mortality rate. Regarding the etiology, cohort studies show that most cases diagnosed in the first trimester have genetic abnormalities as the main cause, with the main associated syndromes being Down, Turner and Edwards syndrome. In the second and third trimesters, hematologic diseases stood out, with thalassemia, followed by cardiac alterations and congenital infections. All causes of fetal hydrops were associated with fetal death, premature birth, and neonatal losses. Conclusion: The studies discussed in this review showed that the main etiologic causes related to non-immune FH are genetic, hematologic, and cardiac abnormalities. The higher the gestational age at diagnosis, the better the prognosis. Studies establishing management/counseling protocols are encouraged.
Downloads
References
Bellini, C., Donarini, G., Paladini, D., Calevo, M. G., Bellini, T., Ramenghi, L. A., & Hennekam, R. C. (2015). Etiology of non-immune hydrops fetalis: An update. American journal of medical genetics. Part A, 167A(5), 1082–1088. https://doi.org/10.1002/ajmg.a.36988
Berger, V. K., Sparks, T. N., Jelin, A. C., Derderian, C., Jeanty, C., Gosnell, K., Mackenzie, T., & Gonzalez, J. M. (2018). Hidrofetal não imune: a placentamegalia e os polihidramnios importam?. Jornal de ultra-som em medicina: jornal oficial do Instituto Americano de Ultra-som em Medicina, 37(5), 1185–1191. https://doi.org/10.1002/jum.14462
DeCS 2024. (2024). São Paulo: BIREME / PAHO / WHO. https://decs.bvsalud.org/en/
Deng, Q., Fu, F., Yu, Q., Li, R., Li, F., Wang, D., Lei, T., Yang, X., & Liao, C. (2020). Hidropos fetais não imunes: Análise genética e resultado clínico. Diagnóstico pré-natal, 40(7), 803–812. https://doi.org/10.1002/pd.5691
Fukushima, K., Morokuma, S., Fujita, Y., Tsukimori, K., Satoh, S., Ochiai, M., Hara, T., Taguchi, T., & Wake, N. (2011). Short-term and long-term outcomes of 214 cases of non-immune hydrops fetalis. Early human development, 87(8), 571–575. https://doi.org/10.1016/j.earlhumdev.2011.04.015
Gilby, D. M., Mee, J. B., Kamlin, C. O. F., Kornman, L. H., Davis, P. G., & Manley, B. J. (2019). Outcomes following antenatal identification of hydrops fetalis: a single-centre experience from 2001 to 2012. Archives of disease in childhood. Fetal and neonatal edition, 104(3), F253–F258. https://doi.org/10.1136/archdischild-2017-313604
Guo, D., He, S., Lin, N., Dai, Y., Li, Y., Xu, L., & Wu, X. (2023). Distúrbios genéticos e resultados de gravidez de hidrops fetal não imunes em um centro de referência terciário. BMC medical genomics, 16(1), 83. https://doi.org/10.1186/s12920-023-01505-y
Huang, H. R., Tsay, P. K., Chiang, M. C., Lien, R., & Chou, Y. H. (2007). Prognostic factors and clinical features in liveborn neonates with hydrops fetalis. American journal of perinatology, 24(1), 33–38. https://doi.org/10.1055/s-2006-958158
Koche, J.C. (2020). Fundamentos de metologia científica: Vozes.
Lee, A. J., Bethune, M., & Hiscock, R. J. (2012). Placental thickness in the second trimester: a pilot study to determine the normal range. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 31(2), 213–218.
Maranto, M., Cigna, V., Orlandi, E., Cucinella, G., Lo Verso, C., Duca, V., & Picciotto, F. (2021). Hidrops fetal não imune: Dois relatos de casos. Jornal mundial de casos clínicos, 9(22), 6531–6537. https://doi.org/10.12998/wjcc.v9.i22.6531
Meng, D., Li, Q., Hu, X., Wang, L., Tan, S., Su, J., Zhang, Y., Sun, W., Chen, B., He, S., Lin, F., Xie, B., Chen, S., Agrawal, P. B., Luo, S., & Fu, C. (2019). Etiology and Outcome of non-immune Hydrops Fetalis in Southern China: report of 1004 cases. Scientific reports, 9(1), 10726. https://doi.org/10.1038/s41598-019-47050-6
Moreno, C. A., Kanazawa, T., Barini, R., Nomura, M. L., Andrade, K. C., Gomes, C. P., Heinrich, J. K., Giugliani, R., Burin, M., & Cavalcanti, D. P. (2013). Non-immune hydrops fetalis: A prospective study of 53 cases. American journal of medical genetics. Part A, 161A(12), 3078–3086. https://doi.org/10.1002/ajmg.a.36171
Reischer, T., Muth, B., Catic, A., Monod, C., Linder, T., Göbl, C., & Yerlikaya-Schatten, G. (2022). Clinical Course and Outcome of Non-Immune Fetal Hydrops in Singleton Pregnancies. Journal of clinical medicine, 11(3), 702. https://doi.org/10.3390/jcm11030702
Santo, S., Mansour, S., Thilaganathan, B., Homfray, T., Papageorghiou, A., Calvert, S., & Bhide, A. (2011). Prenatal diagnosis of non-immune hydrops fetalis: what do we tell the parents?. Prenatal diagnosis, 31(2), 186–195. https://doi.org/10.1002/pd.2677
Sileo, F. G., Kulkarni, A., Branescu, I., Homfray, T., Dempsey, E., Mansour, S., Thilaganathan, B., Bhide, A., & Khalil, A. (2020). Non-immune fetal hydrops: etiology and outcome according to gestational age at diagnosis. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 56(3), 416–421. https://doi.org/10.1002/uog.22019
Society for Maternal-Fetal Medicine (SMFM), Norton, M. E., Chauhan, S. P., & Dashe, J. S. (2015). Society for maternal-fetal medicine (SMFM) clinical guideline #7: nonimmune hydrops fetalis. American journal of obstetrics and gynecology, 212(2), 127–139. https://doi.org/10.1016/j.ajog.2014.12.018
Sparks, T. N., Thao, K., Lianoglou, B. R., Boe, N. M., Bruce, K. G., Datkhaeva, I., Field, N. T., Fratto, V. M., Jolley, J., Laurent, L. C., Mardy, A. H., Murphy, A. M., Ngan, E., Rangwala, N., Rottkamp, C. A. M., Wilson, L., Wu, E., Uy, C. C., Valdez Lopez, P., Norton, M. E., ... Consórcio Fetal-Maternal da Universidade da Califórnia (UCfC) (2019). Hidrops fetal não imune: identificando a etiologia genética subjacente. Genética na medicina: jornal oficial do American College of Medical Genetics, 21(6), 1339–1344. https://doi.org/10.1038/s41436-018-0352-6
Sparks, T. N., Lianoglou, B. R., Adami, R. R., Pluym, I. D., Holliman, K., Duffy, J., Downum, S. L., Patel, S., Faubel, A., Boe, N. M., Field, N. T., Murphy, A., Laurent, L. C., Jolley, J., Uy, C., Slavotinek, A. M., Devine, P., Hodoglugil, U., Van Ziffle, J., Sanders, S. J., … University of California, San Francisco Center for Maternal–Fetal Precision Medicine (2020). Exome Sequencing for Prenatal Diagnosis in Nonimmune Hydrops Fetalis. The New England journal of medicine, 383(18), 1746–1756. https://doi.org/10.1056/NEJMoa2023643
Steurer, M. A., Peyvandi, S., Baer, R. J., MacKenzie, T., Li, B. C., Norton, M. E., Jelliffe-Pawlowski, L. L., & Moon-Grady, A. J. (2017). Epidemiology of Live Born Infants with Nonimmune Hydrops Fetalis-Insights from a Population-Based Dataset. The Journal of pediatrics, 187, 182–188.e3. https://doi.org/10.1016/j.jpeds.2017.04.025
Turgal, M., Ozyuncu, O., Boyraz, G., Yazicioglu, A., & Sinan Beksac, M. (2015). Non-immune hydrops fetalis as a diagnostic and survival problems: what do we tell the parents?. Journal of perinatal medicine, 43(3), 353–358. https://doi.org/10.1515/jpm-2014-0094
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Yasmim Pereira Alves; Danielle Cristine Belisário Scarpin Holsbach
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
