Abstract
Introduction
Fetal hydrops is a serious condition which has high morbidity and mortality. Incidences of immune hydrops have decreased by manifold after introduction of anti-D immunoglobulin. Intra-uterine fetal blood transfusion revolutionized the treatment of these affected fetuses after diagnosis of immune fetal hydrops. In this study we aim to evaluate the clinical characteristics of immune hydropic fetuses and perinatal outcome after institution of intra-uterine transfusions.
Materials and methods
A retrospective study was carried out in pregnant women with immune fetal hydrops from October 2004 to December 2019 in our tertiary care hospital. After diagnosis of fetal hydrops, all the fetuses received intra-uterine transfusions. All the newborns were followed up till 3 months postdelivery. All the fetuses were divided in two groups: hydrops diagnosed below 32 weeks (Group A) and in second group hydrops diagnosed after 32 weeks gestation (Group B).
Results
Total 63 patients were diagnosed to have hydrops during the study period. Group A had 48 fetuses and Group B had 15 fetuses. Average gestational age of diagnosis of hydrops in group A was 24.2 weeks and in group B it was 32.5 weeks. All the fetuses received intra-vascular intra-uterine transfusion. Pericardial effusion was found to be significantly associated with group A. Successful perinatal outcome was seen in 92% fetuses. 87% fetuses had complete resolution of hydrops before delivery. All the fetuses received phototherapy and intra-venous immunoglobulin after delivery, and 5 fetuses underwent exchange transfusion.
Conclusion
Favourable perinatal outcome was achieved in hydropic fetuses with intra-uterine blood transfusions. Complete resolution of hydrops before delivery increases the chances of perinatal survival.
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Devendra Arora, Reema Kumar, Sanjay Singh and Madhusudan Dey declare that they have no conflict of interest.
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Arora Devendra is an Proffesor and Head of the Department of Obstetrics and Gynecology, Base Hosp; Kumar Reema is an Proffessor, Department of Obstetrics and Gynecology, R n R Hospital; Singh Sanjay is an Professor, Department of Obstetrics and Gynecology, Base Hosp; Dey Madhusudan is an Professor, Department of Obstetrics and Gynecology, Base Hosp.
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Devendra, A., Reema, K., Sanjay, S. et al. Our Experience of Immune Fetal Hydrops: its Clinical Characteristics and Perinatal Outcome. J Obstet Gynecol India 71, 239–245 (2021). https://doi.org/10.1007/s13224-020-01423-4
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DOI: https://doi.org/10.1007/s13224-020-01423-4