Successful Outcome of Idiopathic Nonimmune Hydrops Fetalis Treated by Maternal Digoxin

Abstract

Nonimmune hydrops fetalis (NIHF), occurring in 1 in 2,500–3,000 live births, has a reported mortality rate of 50–98%. A similar mortality rate for intrauterine death of fetuses with NIHF probably exists. Many fetal pathological entities have been implicated as causing the condition, but to date, treatment has only been found for cases of fetal tachycardia complicated with hydrops. During a routine ultrasonographic survey of a woman at 32 weeks of gestation, we detected a fetus with severe ascites. There was no apparent etiology, and although no tachycardia was evident, low dosage transplacental digoxin therapy was immediately initiated. The hydropic condition completely resolved within 17 days, and at 39 weeks of gestation, a perfectly normal baby was born after a spontaneous and uneventful labor. This is the first report of successful treatment of idiopathic NIHF with maternal digoxin.

Prenatal diagnosis and management for a large fetal cardiac tumor complicated with hydrops fetalis

“…Furthermore, in utero open surgery has been suggested for an intrapericardial teratoma 10 . The possible role of digoxin has been reported in cases of non‐immune hydrops fetalis 11,12 but the distinct mechanism is still in debate as the etiology was unclear.…”

SFM Fetal Therapy Practice Guidelines: Fetal Medical Therapy

“…Idiopathic nonimmune hydrops fetalis have been experimentally treated with intravenous digoxin and furosemide. 16 17 Digoxin at a dose of 0.25 mg orally twice a day has been used for the same.…”