Advertising Disclaimer
Published online July 2, 2007
PEDIATRICS Vol. 120 No. 1 July 2007, pp. 84-89 (doi:10.1542/peds.2006-3680)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (11)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Abrams, M. E.
Right arrow Articles by Clark, R. H.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Abrams, M. E.
Right arrow Articles by Clark, R. H.
Related Collections
Right arrow Premature & Newborn
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Hydrops Fetalis: A Retrospective Review of Cases Reported to a Large National Database and Identification of Risk Factors Associated With Death

Matthew E. Abrams, MDa,b, Keith S. Meredith, MDa,b, Paula Kinnard, RNa,b, Reese H. Clark, MDa

a Center for Research and Education, Pediatrix Medical Group, Sunrise, Florida
b Division of Neonatology, Phoenix Children's Hospital, Phoenix, Arizona

OBJECTIVES. The objectives were (1) to identify the causes for hydrops fetalis neonates admitted for neonatal intensive care with the diagnosis of hydrops fetalis and (2) to identify the risk factors associated with death.

METHODS. A retrospective review of a large national data set was performed.

RESULTS. There were a total of 253651 discharges from 162 NICUs in the database; 598 patients were identified with a report of hydrops fetalis. The most common associated diagnoses were congenital heart problems (13.7%), abnormalities in heart rate (10.4%), twin-to-twin transfusion (9%), congenital anomalies (8.7%), chromosomal abnormalities (7.5%), congenital viral infections (6.7%), congenital anemia (5%), and congenital chylothorax (3.2%). Of those 598 neonates, 115 were transferred either to another hospital or to another service, 215 died before discharge, and 267 were discharged from the hospital. One patient did not have a discharge type listed and was not included in the outcome analysis. Mortality rates were highest among neonates with congenital anomalies (57.7%) and lowest among neonates with congenital chylothorax (5.9%). Factors that were associated independently with death in logistic regression analyses were younger gestational age, low 5-minute Apgar score, and need for high levels of support during the first day after birth (higher levels of inspired oxygen support and more often treated with high-frequency ventilation).

CONCLUSIONS. The risk of death among neonates with hydrops fetalis depends on the underlying diagnosis and is highest for those who are born more prematurely and those who are most ill immediately after birth. Information from this large study should prove useful for planning prospective studies and providing prenatal counseling to parents with an affected fetus.

Key Words: neonate • hydrops fetalis • death • lung hypoplasia

Accepted Mar 1, 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 NEJMHome page
C. J. Lockwood, A. S. Nadel, M. E. King, and D. J. Roberts
Case 16-2009 -- A 32-Year-Old Pregnant Woman with an Abnormal Fetal Ultrasound Study
N. Engl. J. Med., May 21, 2009; 360(21): 2225 - 2235.
[Full Text] [PDF]