Heinrich-Heine-University, Duesseldorf, Germany.
Praenatal-Medizin und Genetik, Duesseldorf, Germany.
Arch Gynecol Obstet. 2023 Aug;308(2):487-497. doi: 10.1007/s00404-022-06731-w. Epub 2022 Aug 22.
The aim of our study was to investigate spontaneous resolution and postnatal outcome in non-immune hydrops fetalis (NIHF). We specifically studied NIHF cases that occurred without any other anomalies in the prenatal diagnostic workup, defined as isolated NIHF (iNIHF).
To identify iNIHF we retrospectively classified prenatal findings of 700 NIHF singletons, diagnosed in our prenatal referral center between 1997 and 2016. We studied the occurrence of prenatal resolution in iNIHF and linked it to the perinatal outcome. We obtained long-term outcome by contacting the parents, children, and the pediatricians and listed all functional and structural anomalies and temporary logopedic, psychosocial and motoric impairments.
Among 70 iNIHF cases, 54 (77.1%) resolved completely prenatally. The baby-take-home rate was 98.1% in these cases. In contrast, the baby-take-home rate in the subgroup without complete resolution was 25.0%. We achieved pediatric long-term outcome in 27 of 57 survivors (47.4%) of iNIHF with a mean follow-up period of 10.9 years. Among these 27 children, fetal hydrops had completely resolved prenatally in 26 cases and had regressed to a mild effusion in one case. In the pediatric development, two children had significant functional impairment and two children showed recurrent skin edema.
Complete spontaneous resolution was the most common intrauterine course of iNIHF in our collective. Completely resolved iNIHF had a favorable perinatal outcome in our study. Our data on the long-term outcomes are consistent with the assumption of an increased rate of functional impairments.
Internal study number of Heinrich-Heine-University, Duesseldorf: 6177R. Date of registration: December 2017.
本研究旨在探讨非免疫性胎儿水肿（NIHF）的自发性消退和产后结局。我们特别研究了在产前诊断工作中没有任何其他异常的 NIHF 病例，将其定义为孤立性 NIHF（iNIHF）。
为了识别 iNIHF，我们回顾性地对 1997 年至 2016 年在我们的产前转诊中心诊断的 700 例 NIHF 单胎病例进行分类。我们研究了 iNIHF 的产前消退情况，并将其与围产期结局相关联。我们通过联系父母、孩子和儿科医生获得了长期结局，并列出了所有功能和结构异常以及暂时的言语治疗、心理社会和运动障碍。
在 70 例 iNIHF 病例中，54 例（77.1%）完全在产前消退。在这些病例中，婴儿出院率为 98.1%。相比之下，无完全消退的亚组婴儿出院率为 25.0%。我们在 57 例 iNIHF 幸存者中的 27 例（47.4%）中获得了儿科长期结局，平均随访期为 10.9 年。在这 27 名儿童中，26 例胎儿水肿在产前完全消退，1 例消退为轻度积液。在儿科发育方面，有 2 名儿童存在明显的功能障碍，2 名儿童出现皮肤水肿反复发作。
完全自发消退是我们研究中 iNIHF 最常见的宫内过程。在我们的研究中，完全消退的 iNIHF 具有良好的围产期结局。我们关于长期结局的数据与功能障碍发生率增加的假设一致。
杜塞尔多夫海因里希-海涅大学内部研究编号：6177R。注册日期：2017 年 12 月。
