Kaczmarek Piotr, Jaczewski Bogumił, Oszukowski Przemysław, Respondek-Liberska Maria
Ginekol Pol. 2003 Oct;74(10):1112-7.
The aim of the research was to assess whether all reasons of NIHF were leading to the same poor outcome.
The material of the research study consisted of 192 fetuses with follow up from 230 fetuses with NIHF who had echocardiography and detailed sonography between 1992 and 2002.
The most common anomalies associated with NIHF were cardiological anomalies n = 71 (30.8). The remain extracardiac causes of NIHF were: so called "other structural defects" n = 24 (10.4%), infections (without myocarditis) n = 24 (10.4%), multiple structural defects n = 20 (8.7%), urogenital defects n = 17 (7.4%), pulmonary anomalies n = 17 (7.4%), gastrointestinal anomalies n = 12 (5.2%), chromosomal defects n = 8 (3.5%), mirror syndrome n = 2 (0.9%) and idiopathic n = 35 (15.3%). In the group of NIHF 102 fetuses (44.3%) presented echocardiographic signs of congestive heart failure which statistically increased mortality ratio. In the group of fetuses with NIHF follow up was established in 192 (83.4%) fetuses/newborns; there were n = 139 (72.4%) demise and n = 53 (27.6%) alive. Therapy in utero was applied to 28 cases. In this group 13 fetuses/newborns (46.4%) survived.
Multiple structural anomalies and cardiological anomalies causing NIHF are connected with poor prognosis for fetus or neonate. Congestive heart failure coexisting with NIHF (in our series in about 44%) significantly increased mortality ratio what point the special role of fetal echocardiography. Relatively better prognosis was observed possible in cases with NIHF without structural anomalies and mild intensify or due to infection but without cardiac anomalies. In selected fetuses therapy in utero may increase the survival ratio.
本研究旨在评估非免疫性胎儿水肿（NIHF）的所有病因是否都会导致同样不良的结局。
本研究的材料包括192例胎儿，这些胎儿来自于1992年至2002年间接受超声心动图和详细超声检查的230例NIHF胎儿，并进行了随访。
与NIHF相关的最常见异常为心脏异常，共71例（30.8%）。其余NIHF的心脏外病因包括：所谓的“其他结构缺陷”24例（10.4%）、感染（无心肌炎）24例（10.4%）、多发结构缺陷20例（8.7%）、泌尿生殖系统缺陷17例（7.4%）、肺部异常17例（7.4%）、胃肠道异常12例（5.2%）、染色体缺陷8例（3.5%）、镜像综合征2例（0.9%）以及特发性35例（15.3%）。在NIHF组中，102例胎儿（44.3%）出现了充血性心力衰竭的超声心动图表现，这在统计学上增加了死亡率。在NIHF胎儿组中，对192例（83.4%）胎儿/新生儿进行了随访；其中139例（72.4%）死亡，53例（27.6%）存活。对28例进行了宫内治疗。在该组中，13例胎儿/新生儿（46.4%）存活。
导致NIHF的多发结构异常和心脏异常与胎儿或新生儿的不良预后相关。与NIHF并存的充血性心力衰竭（在我们的系列研究中约占44%）显著增加了死亡率，这突出了胎儿超声心动图的特殊作用。在无结构异常、程度较轻或由感染但无心脏异常导致的NIHF病例中，观察到相对较好的预后。在部分胎儿中，宫内治疗可能会提高存活率。
