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Etiology and outcome of non-immune hydrops fetalis in relation to gestational age at diagnosis and intrauterine treatment



To determine the etiology and outcome of non-immune hydrops fetalis (NIHF) according to gestational age at diagnosis and intrauterine treatment.

Study design

A total of 122 NIHF cases were included. Medical records and ultrasonographic images were reviewed. The etiology, outcome, and intrauterine treatment were assessed.


The etiology was determined in 100 cases, and Hb Bart’s disease was the most common. Two cases each of homozygous Southeast Asian ovalocytosis (SAO) and hemoglobin Constant Spring (Hb CS) were found. NIHF diagnosed in early gestation (<24 weeks) had a higher rate of chromosomal abnormalities and fetal demise. Intrauterine treatment was given in 18 cases, and 50% had successful live births.


Hb Bart’s disease was the most common cause of NIHF. SAO and Hb CS were associated with hydrops. NIHF in gestational age <24 weeks was associated with chromosomal abnormalities and fetal demise. Intrauterine treatment should be offered in selected cases.

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The study was supported by the Prince of Songkla University, Songkhla, Thailand. The authors would like to thank Miss Jirawan Jayuphan from the Epidemiology Unit, Faculty of Medicine, Prince of Songkla University for her assistance in data analysis. We also would like to thank Mr. Dave Patterson from the International Affairs Office, Faculty of Medicine, Prince of Songkla University for English language editing.

Author information




N.C. and W.M. designed, planned, and conducted the study. N.C., W.M., and C.S. contributed to the data analysis and to the first and final drafts of the manuscript.

Corresponding author

Correspondence to Natthicha Chainarong.

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Competing interests

The authors declare no competing interests.

Ethical approval

This study was performed in accordance with the Declaration of Helsinki and approval was obtained from the Human Research Ethics Committee of the Faculty of Medicine, Prince of Songkla University before the study began.

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Chainarong, N., Muangpaisarn, W. & Suwanrath, C. Etiology and outcome of non-immune hydrops fetalis in relation to gestational age at diagnosis and intrauterine treatment. J Perinatol 41, 2544–2548 (2021).

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