Okai T, Baba K, Kohzuma S, Mukuboh M, Shi S, Mizuno M, Sakamoto S
Nihon Sanka Fujinka Gakkai Zasshi. 1984 Oct;36(10):1813-21.
Thirty cases of nonimmunologic hydrops fetalis in 14 hospitals were studied. The incidence of nonimmunologic hydrops fetalis was 1 in 4,330 deliveries at all hospitals and 1 in 4,389 deliveries at Tokyo University Hospital. Among these, 13 cases with various kinds of fetal anomalies and 5 cases complicated by twin to twin transfusion syndrome were found. Polyhydramnios (73%), preeclampsia (20%), anemia (34%), and hypoproteinemia (64%) were the commonest prenatal maternal complications, whereas a high incidence of abnormal NST patterns such as loss of variability was found, although urinary E3 levels were within the normal range. High rates of premature labor, Caesarian section and vacuum extraction were found at the deliveries of nonimmunologic hydrops fetalis. Prenatal diagnoses were made in 30% and 85% of the cases before 1977 and between 1978 and 1982, respectively. Ultrasound examination was confirmed to be very useful in detecting the hydropic state in the later period. The perinatal mortality rate from nonimmunologic hydrops fetalis was high (90%); and it was 100% in the cases with anomalies or twin to twin transfusion syndrome. The main cause of neonatal death was respiratory insufficiency due to hypoplasty of the lungs and pleural effusion.
对14家医院的30例非免疫性胎儿水肿病例进行了研究。所有医院非免疫性胎儿水肿的发生率为4330例分娩中有1例，东京大学医院为4389例分娩中有1例。其中，发现13例有各种胎儿异常，5例并发双胎输血综合征。羊水过多（73%）、先兆子痫（20%）、贫血（34%）和低蛋白血症（64%）是最常见的产前母体并发症，尽管尿E3水平在正常范围内，但发现异常NST模式（如变异性丧失）的发生率很高。非免疫性胎儿水肿分娩时早产、剖宫产和真空吸引的发生率很高。1977年以前和1978年至1982年期间，分别有30%和85%的病例作出了产前诊断。超声检查被证实对检测后期的水肿状态非常有用。非免疫性胎儿水肿的围产期死亡率很高（90%）；有异常或双胎输血综合征的病例中死亡率为100%。新生儿死亡的主要原因是肺发育不全和胸腔积液导致的呼吸功能不全。
