Category: Ultrasound/Imaging
Poster Session I
Non-immune hydrops fetalis (NIHF) and fetal effusions are known to have poor perinatal outcomes. However, it is not well understood how often or in which cases the effusions can resolve. We utilized a large cohort to describe the frequency with which fetal effusions resolve as well as features of cases in which resolution occurs.
Study Design:
Secondary analysis of cases with pleural effusions, pericardial effusions, ascites, and/or skin edema from 2 large studies conducted at our institution over 2017 to 2022. Some cases had a genetic diagnosis identified with karyotype or microarray, and those unexplained after initial genetic and other relevant tests then underwent exome sequencing. Detailed medical record data was extracted, including fetal effusions present, gestational age at resolution, fetal procedures, genetic diagnoses, and concurrent anomalies. Chi square test compared proportions and logistic regression generated odds ratios.
Results: 210 cases with NIHF and fetal effusions were identified, 111 of which resulted in termination or stillbirth. Among the 99 continuing pregnancies, 19% (19) resulted in resolution of fetal effusions, 14% (14) being spontaneous resolution without a fetal procedure, and 5% (5) following a fetal procedure. Median gestational age was 30 weeks 6 days for spontaneous resolution of fetal effusions, and 34 weeks 5 days after a fetal procedure. Among cases where fetal effusions resolved, 16% (3/19) had a definitive genetic diagnosis compared to 35% (28/80) where they persisted (p=0.10). Genetic diagnoses in resolved cases included Noonan, KBG, and Imagawa Matsumoto syndromes. Odds of resolution with a definitive genetic diagnosis were 0.35 (95% CI 0.09-1.30), adjusting for the presence of any concurrent anomaly.
Conclusion:
Among continuing pregnancies with pleural effusions, pericardial effusions, ascites, and/or skin edema, resolution of fetal effusions occurs most frequently in the third trimester. Spontaneous resolution occurs in 14% of cases, and there is not an apparent association with underlying genetic diagnoses or fetal anomalies.
Teresa N. Sparks, MD, MAS
Maternal-Fetal Medicine and Clinical Genetics
University of California, San Francisco
San Francisco, California, United States
Billie R. Lianoglou, MS
Genetic Counselor
University of California, San Francisco
San Francisco, California, United States
Nuriye Sahin Hodoglugil, PhD
Program Manager
Division of Maternal Fetal Medicine
San Francisco, California, United States
Kate Swanson, MD (she/her/hers)
Physician
NorthShore University Health System
Evanston, Illinois, United States
Sarah L. Downum, BS
Clinical Research Coordinator, Pre-med student
University of California, San Francisco
San Francisco, California, United States
Patrick Devine, MD, PhD
University of California, San Francisco
San Francisco, California, United States
Ugur Hodoglugil, MD, PhD
Clinical Information Specialist
University of California, San Francisco
San Francisco, California, United States
Jessica Van Ziffle, PhD
University of California, San Francisco
San Francisco, California, United States
Mary E. Norton, MD
Division Chief, MFM, Dept of Obstetrics, Gynecology & Reproductive Sciences
University of California, San Francisco
San Francisco, California, United States