Etiology and Outcome of Non-Immune Hydrops fetalis in Southern Thailand

• Published in: Gynecologic and obstetric investigation Vol. 59; no. 3; pp. 134 - 137
• Main Authors: Suwanrath-Kengpol, Chitkasaem, Kor-anantakul, Ounjai, Suntharasaj, Thitima, Leetanaporn, Roengsak
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2005; S. Karger AG
• Subjects: Adolescent; Adult; Anemias. Hemoglobinopathies; Aneuploidy; Biological and medical sciences; Diseases of mother, fetus and pregnancy; Diseases of red blood cells; Female; Gestational Age; Gynecology. Andrology. Obstetrics; Heart Defects, Congenital - complications; Hematologic and hematopoietic diseases; Hemoglobins, Abnormal; Humans; Hydrops Fetalis - diagnosis; Hydrops Fetalis - etiology; Hydrops Fetalis - genetics; Infection - complications; Maternal Age; Medical sciences; Middle Aged; Original Article; Pregnancy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Thailand; Thailand; Asia; Hb Bart's disease; Thalassemia; Non-immune hydrops fetalis; Hydrops fetalis; Hemoglobinopathy; Prognosis; Pregnancy disorders; Gynecology; Hb Bart's disease # Non-immune hydrops fetalis; Hemopathy; Obstetrics; Genetic disease; Fetal diseases; Hemolytic anemia; Etiology; α-Thalassemia
• ISSN: 0378-7346; 1423-002X
• DOI: 10.1159/000082997

Objective: To study the etiology and outcome of non-immune hydrops fetalis in southern Thailand. Methods: The medical records and videotape recordings of all pregnant women diagnosed with non-immune fetal hydrops, from January 1993 to December 2002 were reviewed. Results: Non-immune hydrops fetalis was documented in 71 cases. The causes of fetal hydrops were identified in 87.3%. Homozygous α-thalassemia-1 dominated as the cause of non-immune fetal hydrops (28.2%), followed by structural abnormalities (15.5%) and infection (12.7%). The underlying etiology remained unknown in 9 cases (12.7%). The overall survival rate of non-immune hydrops fetalis cases was 4.2%. Spontaneous regression occurred in 2 cases. Two cases were lost to follow up after initial evaluation. Termination of pregnancy was performed in 47 cases. There were 12 dead fetuses in utero, 2 stillbirths, 5 early neonatal deaths and only 3 cases survived. Conclusions: Homozygous α-thalassemia-1 is the most common cause of non-immune hydrops fetalis in southern Thailand, and the overall prognosis of non-immune hydrops fetalis is poor. We suggest that an effective thalassemia-screening program for prevention and control of homozygous α-thalassemia-1 be established in all areas where the α-thalassemia-1 gene is prevalent.