Non-immune hydrops after 20 weeks' gestation: Review of 10 years' experience with suggestions for management

To analyze the etiologies and outcomes for a southeastern section of the United States, and to organize an efficient approach to evaluation. We reviewed 82 cases of non-immune hydrops presenting after 20 weeks' gestation over a 10-year period. Overall perinatal mortality was 86.6%. Fetuses diagnosed with hydrops before 24 weeks' gestation had a perinatal mortality of 95%, with nearly one-third having abnormal karyotypes. The etiology of hydrops diagnosed after 24 weeks' gestation was more likely to remain idiopathic or to be related to cardiothoracic abnormalities. Before 24 weeks' gestation, the high risk of mortality and abnormal karyotype justifies offering families funipuncture in the hope of finding a treatable cause of non-immune hydrops. After 24 weeks' gestation, when fewer abnormal karyotypes are found, funipuncture may also be pivotal in diagnosing the cause of non-immune hydrops.