A seven-year retrospective cohort study on non-immune foetal hydrops from a single centre in an LMIC setting.

OBJECTIVES

To study the clinical profile, aetiology and outcomes of foetuses diagnosed with non-immune hydrops (NIHF) at a single centre between 2016 and 2023.

METHODS

Pregnancies diagnosed with NIHF were studied retrospectively, using the antenatal records and neonatal electronic database.

RESULTS

Ninety-two foetuses were diagnosed with NIHF including 8 sets of twins. Majority (64 %) were diagnosed in second trimester followed by 25 % in first trimester. One fourth (24 %, n=22) had IUFD (Intrauterine foetal demise) at diagnosis. Congenital anomalies were present in (57 %, 52) most common being cystic hygroma, (10/52) followed by foetal chylothorax and cardiac anomalies. Multiple anomalies were present in 15 % cases. Genetic evaluation, either chromosomal and/or DNA based test was done only in 62 % (57/92). More than one third (39 %, 22) had an abnormal karyotype, most common being 45, XO in 54 %, (12/22) followed by trisomy 21(9/22, 41 %). Twin-to-twin transfusion syndrome (TTTS) was seen in 75 % twins. Overall, most common etiologies were genetic, congenital anomalies, and unknown seen in 30 %, 26 %, and 23 % respectively. Majority of those with unknown aetiology were not/partially evaluated (13/21, 62 %). Recurrent NIHF was seen in 8 women. Two of them were diagnosed to have monogenic disorder while another one was carrier of a balanced chromosomal translocation.

CONCLUSIONS

Genetic aetiology was found in one third. The most common cause in twins was TTTS. One fifth had unknown aetiology, mostly due to lack of complete diagnostic work up.