Characterization of newborns with nonimmune hydrops fetalis admitted to a neonatal intensive care unit

RESUMO

PURPOSE: To determine the incidence and characteristics of nonimmune hydrops fetalis in the newborn population. METHOD: A retrospective study of the period between 1996 and 2000, including all newborns with a prenatal or early neonatal diagnosis of nonimmune hydrops fetalis, based on clinical history, physical examination, and laboratory evaluation. The following were analyzed: prenatal follow-up, delivery type, gender, birth weight, gestational age, presence of perinatal asphyxia, nutritional classification, etiopathic diagnosis, length of hospital stay, mortality, and age at death. RESULTS: A total of 47 newborns with hydrops fetalis (0.42 percent of live births), 18 (38.3 percent) with the immune form and 29 (61.7 percent) with the nonimmune form, were selected for study. The incidence of nonimmune hydrops fetalis was 1 per 414 neonates. Data was obtained from 21 newborns, with the following characteristics: 19 (90.5 percent) were suspected from prenatal diagnosis, 18 (85.7 percent) were born by cesarean delivery, 15 (71.4 percent) were female, and 10 (47.6 percent) were asphyxiated. The average weight was 2665.9 g, and the average gestational age was 35 3/7 weeks; 14 (66.6 percent) were preterm; 18 (85.0 percent) appropriate delivery time; and 3 (14.3 percent) were large for gestational age. The etiopathic diagnosis was determined for 62 percent, which included cardiovascular (19.0 percent), infectious (9.5 percent), placental (4.8 percent), hematologic (4.7 percent), genitourinary (4.8 percent), and tumoral causes (4.8 percent), and there was a combination of causes in 9.5 percent. The etiology was classified as idiopathic in 38 percent. The length of hospital stay was 26.6 ± 23.6 days, and the mortality rate was 52.4 percent. CONCLUSIONS: The establishment of a suitable etiopathic diagnosis associated with prenatal detection of nonimmune hydrops fetalis can be an important step in reducing the neonatal mortality rate from this condition