Etiology of Hydrops Fetalis at the Philippine General Hospital: A Retrospective Study
Objective. Hydrops fetalis (HF) is a diagnosis with significant morbidity and mortality. It is the objective of this study to identify common etiologic causes of HF in the Philippine General Hospital (PGH).
Methods. This is a retrospective review of hydrops fetalis cases delivered at the PGH from 2010 to 2014. There was a total of 75 identified cases of hydrops fetalis. However, only 58 of these, or 77.33% have available medical charts for review.
Results. The median gestational age at birth was 31 (range 2140) weeks. There were 19 identified cases (32%) of stillbirth. Of the 32 patients born alive, 30 (93.75%) died in the immediate neonatal period. The etiologies of HF were identified in 15 cases, which included congenital anomalies (n=4), cardiac anomalies (n=3), infectious problems (n=3), hematologic anomalies (n=2), placental anomalies (n=2) and congenital tumor (n=1). Cases of congenital anomalies were only detected by congenital anomaly scan; no further work-ups were done. Fifteen (15) mothers presented with microcytic, hypochromic anemia on complete blood count (CBC). The cause of HF was not confirmed in the remaining 43 (74%) cases.
Conclusion. It is important to fully investigate the causes of HF to aid in the proper management and counseling. Further work-up must be done for mothers presenting with microcytic, hypochromic anemia. This is an important feature of alpha thalassemia. Partners of women suspected to have alpha thalassemia should also have a hematologic screening. The deletion of the four alpha genes will result to HB Bart’s hydrops fetalis; a major cause of hydrops fetalis in Southeast Asian countries.