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Federación Mexicana de Ginecología y Obstetricia, A.C.

2022, Number 07

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Ginecol Obstet Mex 2022; 90 (07)

Etiology of fetal hydrops: experience in an obstetric hospital in western Mexico

Becerra-Solano LE, Medina-Castellanos M, Oseguera-Torres LF, Mendoza-Ruvalcaba SC, Domínguez-Quezada MG, García-Ortiz JE

Language: Spanish
References: 36
Page: 579-589
PDF size: 220.98 Kb.


ABSTRACT

Objective: To identify the causes of nonimmune fetal hydrops fetalis in an obstetric referral hospital in Western Mexico.
Materials and Methods: Case series study, with non-probabilistic sampling by convenience, carried out from October 2014 to September 2015 which included patients (between 15 and 38 weeks of pregnancy), of legal age (in cases of minors, informed consent was requested from parents or guardians), with a diagnosis of fetal hydrops fetalis by obstetric ultrasound. For statistical analysis, an Excel database was generated and descriptive statistics were applied.
Results: Thirty-three pregnant women were included, in whom non-immune fetal hydrops fetalis was the most frequent (94%) and idiopathic was the most common cause (n = 10), followed by inborn errors of metabolism, chromosomal and cardiac alterations (n = 6 each). This was followed by hematologic (n = 4), lymphatic and syndromic causes (n = 3 each), and infectious and tumor causes (n = 1 each). In this study, inborn errors of metabolism (specifically Sly syndrome) had a higher frequency than that reported in the literature.
Conclusions: Inborn errors of metabolism, chromosomal and cardiac abnormalities were the second most frequent cause of nonimmune fetal hydrops. It is suggested that metabolic causes be taken into account in the diagnostic approach to fetal hydrops, especially for the establishment of early treatment.


REFERENCES

  1. Mardy AH, Chetty SP, Norton ME, Sparks TN. A systembasedapproach to the genetic etiologies of non-immunehydrops fetalis. Prenat Diagn 2019; 39 (9): 732-50. doi:10.1002/pd.5479

  2. Désilets V, Audibert F; Society of Obstetrician and Gynaecologistsof Canada. Investigation and management ofnon-immune fetal hydrops. J Obstet Gynaecol Can 2013;

  3. 35 (10): 923-38. doi: 10.1016/s1701-2163(15)30816-13. Al-Kouatly HB, Felder L, Makhamreh MM, Kass SL, et at. Lysosomalstorage disease spectrum in nonimmune hydropsfetalis: a retrospective case control study. Prenat Diagn2020; 40 (6): 738-45. doi: 10.1002/pd.5678

  4. Deng Q, Fu F, Yu Q, Li R, et al. Nonimmune hydrops fetalis:Genetic analysis and clinical outcome. Prenat Diagn 2020;40 (7): 803-12. doi: 10.1002/pd.5691

  5. Swearingen C, Colvin ZA, Leuthner SR. NonimmuneHydrops Fetalis. Clin Perinatol 2020; 47 (1): 105-21. doi:10.1016/j.clp.2019.10.001

  6. van Diggelen OP, Zhao H, Kleijer WJ, Janse HC, et al. Afluorimetric enzyme assay for the diagnosis of Morquiodisease type A (MPS IV A). Clin Chim Acta 1990; 187 (2):131-9. doi: 10.1016/0009-8981(90)90339-t

  7. Beaudet AL, DiFerrante NM, Ferry GD, Nichols BL Jr, et al.,Variation in the phenotypic expression of beta-glucuronidasedeficiency. J Pediatr 1975; 86 (3): 388-94. doi: 10.1016/s0022-3476(75)80968-1

  8. Mendoza-Ruvalcaba SDC, Brambila-Tapia AJL, Juárez-OsunaJA, Silva-José TDD, et al. Biochemical diagnosis of mucopolysaccharidosisin a Mexican reference center. Genet MolBiol 2020; 43 (1): e20180347. doi: 10.1590/1678-4685-GMB-2018-0347

  9. Hollak CE, van Weely S, van Oers MH, Aerts JM. Marked elevationof plasma chitotriosidase activity. A novel hallmarkof Gaucher disease. J Clin Invest 1994; 93 (3): 1288-92. doi:

  10. 10.1172/JCI11708410. Chamoles NA, Blanco M, Gaggioli D, Casentini C. Gaucherand Niemann-Pick diseases--enzymatic diagnosis in driedblood spots on filter paper: retrospective diagnoses innewborn-screening cards. Clin Chim Acta 2002; 317 (1-2):191-7. doi: 10.1016/s0009-8981(01)00798-7

  11. Thalhammer S, Koehler U, Stark RW, Heckl WM. GTG bandingpattern on human metaphase chromosomes revealedby high resolution atomic-force microscopy. J Microsc 2001;202 (Pt 3): 464-7. doi: 10.1046/j.1365-2818.2001.00909.x

  12. Mari G. Doppler ultrasonography in obstetrics: from thediagnosis of fetal anemia to the treatment of intrauterinegrowth-restricted fetuses. Am J Obstet Gynecol 2009; 200(6): 613.e1-9. doi: 10.1016/j.ajog.2008.10.054

  13. Durigon EL, Erdman DD, Gary GW, Pallansch MA, et al.Multiple primer pairs for polymerase chain reaction(PCR) amplification of human parvovirus B19 DNA. JVirol Methods 1993; 44 (2-3): 155-65. doi: 10.1016/0166-0934(93)90051-r

  14. Santo S, Mansour S, Thilaganathan B, Homfray T, et al.Prenatal diagnosis of non-immune hydrops fetalis: whatdo we tell the parents? Prenat Diagn 2011; 31 (2): 186-95.doi: 10.1002/pd.2677

  15. Moreno CA, Kanazawa T, Barini R, Nomura ML, et al. Nonimmunehydrops fetalis: A prospective study of 53 cases.Am J Med Genet A 2013; 161A (12): 3078-86. doi: 10.1002/ajmg.a.36171

  16. Whybra C, Mengel E, Russo A, Bahlmann F, et al. Lysosomalstorage disorder in non-immunological hydrops fetalis(NIHF): more common than assumed? Report of four caseswith transient NIHF and a review of the literature. OrphanetJ Rare Dis 2012; 7: 86. doi: 10.1186/1750-1172-7-86

  17. Emiroğlu N, Yılmaz FH, Keçeci R, Yücel M, et al. Clinical characteristicsand neonatal outcomes of liveborn newbornswith hydrops fetalis treated in a tertiary level neonatalintensive care unit. Birth Defects Res 2020; 112 (6): 515-22.doi: 10.1002/bdr2.1640

  18. Sparks TN, Thao K, Lianoglou BR, Boe NM, et al; Universityof California Fetal–Maternal Consortium (UCfC). Nonimmunehydrops fetalis: identifying the underlying geneticetiology. Genet Med 2019; 21 (6): 1339-44. doi: 10.1038/s41436-018-0352-6.

  19. Gimovsky AC, Luzi P, Berghella V. Lysosomal storage diseaseas an etiology of nonimmune hydrops. Am J Obstet Gynecol

  20. 2015; 212 (3): 281-90. doi: 10.1016/j.ajog.2014.10.00720. Bellini C, Hennekam RC. Non-immune hydrops fetalis:a short review of etiology and pathophysiology. Am JMed Genet A 2012; 158A (3): 597-605. doi: 10.1002/ajmg.a.34438

  21. Bellini C, Donarini G, Paladini D, Calevo MG, et al. Etiologyof non-immune hydrops fetalis: An update. Am J Med GenetA 2015; 167A (5): 1082-8. doi: 10.1002/ajmg.a.36988

  22. McCoy MC, Katz VL, Gould N, Kuller JA. Non-immune hydropsafter 20 weeks' gestation: review of 10 years' experiencewith suggestions for management. Obstet Gynecol1995; 85 (4): 578-82. doi: 10.1016/0029-7844(94)00444-i

  23. Savirón R, Cotaina L, Odriozola M, Campillos JM, et al.Síndrome de Ballantyne (síndrome del espejo - mirrorsyndrome). Rev Chil Obstet Ginecol 2013; 78 (3): 224-8.doi.10.4067/S0717-75262013000300009

  24. Sudrié-Arnaud B, Marguet F, Patrier S, Martinovic J, et al.Metabolic causes of nonimmune hydrops fetalis: A next-generationsequencing panel as a first-line investigation. ClinChim Acta 2018; 481: 1-8. doi: 10.1016/j.cca.2018.02.023

  25. Furlan F, Rovelli A, Rigoldi M, Filocamo M, et al. A new casereport of severe mucopolysaccharidosis type VII: diagnosis,treatment with haematopoietic cell transplantation andprenatal diagnosis in a second pregnancy. Ital J Pediatr2018 ; 44(Suppl 2): 128. doi: 10.1186/s13052-018-0566-x

  26. Holtz M, Montaño AM, Sly WS. Association between mucopolysaccharidosisType VII and hydrops fetalis. UltrasoundObstet Gynecol 2020; 55 (3): 416-7. doi: 10.1002/uog.20371

  27. Favre R, Dreux S, Dommergues M, Dumez Y, et al. Nonimmunefetal ascites: a series of 79 cases. Am J Obstet Gynecol2004; 190 (2): 407-12. doi: 10.1016/j.ajog.2003.09.016

  28. Iskaros J, Jauniaux E, Rodeck C. Outcome of nonimmunehydrops fetalis diagnosed during the first half of pregnancy.Obstet Gynecol 1997; 90 (3): 321-5. doi: 10.1016/s0029-7844(97)00290-1

  29. Abdel-Fattah SA, Bhat A, Illanes S, Bartha JL, et al. TORCHtest for fetal medicine indications: only CMV is necessary inthe United Kingdom. Prenat Diagn 2005; 25 (11): 1028-31.doi: 10.1002/pd.1242

  30. Landolsi H, Yacoubi MT, Bouslama L, Lahmar A, et al. Detectionof the human Parvovirus B19 in nonimmune hydropsfetalis using immunohistochemistry and nested-PCR informalin-fixed and paraffin-embedded placenta and fetaltissues. Pathol Biol (Paris) 2009; 57 (3): e1-7. doi: 10.1016/j.patbio.2007.11.001

  31. Smith C, Teng F, Branch E, Chu S, et al. Maternal and PerinatalMorbidity and Mortality Associated With Anemiain Pregnancy. Obstet Gynecol 2019; 134 (6): 1234-44. doi:10.1097/AOG.0000000000003557

  32. Kumar M, Jha V, Singh A. Nonimmune Hydrops Fetalis:Factors Which Predict Outcome. J Obstet Gynaecol India2018; 68 (3): 197-203. doi: 10.1007/s13224-017-1011-6

  33. Shamah-Levy T, Villalpando-Hernández S, García-GuerraA, Mundo-Rosas V, et al. Anemia in Mexican women:results of two national probabilistic surveys. Salud PublicaMex 2009; 51 Suppl 4: S515-22. doi: 10.1590/s0036-36342009001000006

  34. Braun T, Brauer M, Fuchs I, Czernik C, et al. Mirror syndrome:a systematic review of fetal associated conditions,maternal presentation and perinatal outcome. Fetal DiagnTher 2010; 27 (4): 191-203. doi: 10.1159/000305096

  35. Gort L, Granell MR, Fernández G, Carreto P, et al. Fast protocolfor the diagnosis of lysosomal diseases in nonimmunehydrops fetalis. Prenat Diagn 2012; 32 (12): 1139-42. doi:10.1002/pd.3972

  36. Has R. Non-immune hydrops fetalis in the first trimester:a review of 30 cases. Clin Exp Obstet Gynecol 2001; 28(3): 187-90.




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