Hidropisia fetal: análise de 80 casos Fetal hydrops: analysis of 80 cases

OBJETIVO: descrever a etiologia, evolução e prevalência de hidropisia fetal em coorte de gestantes em 10 anos de acompanhamento (1992 a 2002), em uma maternidade terciária. MÉTODOS: estudo retrospectivo foi realizado em pacientes referidas para a maternidade do Instituto Fernandes Figueira com o diagnóstico de hidropisia fetal, detectado pelo exame de ultra-sonografia, durante o período compreendido entre 1992 e 2002. Os casos foram selecionados quanto à etiologia (imune ou não-imune), sendo comparados quanto à evolução, procedimentos invasivos realizados e sobrevivência. A análise das variáveis foi realizada por meio do programa Epi-Info 6.0, sendo considerado valor de significância estatística um valor de pPURPOSE: to describe etiology, evolution and prevalence of hydrops fetalis in a cohort of pregnant women during a period of ten years (1992 to 2002) in a tertiary maternity. METHODS: a retrospective study was carried out in patients referred to the maternity of the Fernandes Figueira Institute, with diagnosis of hydrops fetalis, detected by ultrasonography, during the period from 1992 to 2002. The cases were selected according to etiology (immune or nonimmune) and evolution, performed invasive procedures and survival were compared between both groups. Analysis of variables was performed by Epi-Info 6.0 and a p value less than 0.05 was considered to be statistical significant. RESULTS: in ten years of follow-up, 80 patients with an initial diagnosis of hydrops were attended. The frequency of hydrops in this population was 1 in 157 live births. Rh immunization (immune group) was detected in 13 cases (16.2%), and for 67 cases (83.8%) nonimmune causes (nonimmune group) were considered. Major causes of nonimmune hydrops fetalis were idiopathic (40.2%), genetic (20.8%), infectious diseases (20.7%), and cardiopathy (7.4%). A difference was found in relation to maternal age in the immune group (mean = 32.8 years) when compared with the nonimmune group (mean = 28.7 years) (p=0.03), but gestational age at delivery was similar in both groups (mean = 33.6 weeks in the immune group and 33.1 weeks in the nonimmune group) (p=0.66). Amniocentesis and blood transfusion in utero were carried out more frequently in the immune group (p