Ultrasonographic severity scoring of non-immune hydrops: A predictor of perinatal mortality

Su Ah Kim, Seung Mi Lee, Joon Seok Hong, Joon Ho Lee, Chan Wook Park, Byoung Jae Kim, Kyo Hoon Park, Joong Shin Park, Jong Kwan Jun

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Aim: To develop an ultrasonographic severity scoring of non-immune hydrops in order to predict perinatal outcomes in women with non-immune hydrops. Methods: The study population consisted of pregnant women who were admitted and delivered with the diagnosis of fetal non-immune hydrops and singleton gestation. Cases were divided into "perinatal survivor" and "perinatal non-survivor" groups. Perinatal non-survivor cases were defined as those with stillbirth or neonatal death ≤28 completed days after birth. The presence of an abnormal fluid collection in each body compartment, such as subcutaneous edema, pleural effusion, pericardial effusion, or ascites was assigned a score of 1 point per each body compartment, and the absence of abnormal fluid collection was scored as 0 point. The total number of abnormal fluid collections was converted to a numeric score, which was called the ultrasonographic severity scoring of nonimmune hydrops (USNIH). Results: Perinatal death occurred in 46.5% (20/43) of the cases of non-immune hydrops. USNIH in patients of the non-survivor group was significantly higher than that in those of the survivor group [non-survivor group 3 (2-4) vs. survivor 2 (2-3); median (range); P<0.05]. Perinatal mortality rates were higher in patients with USNIH ≥3 points than in those with USNIH of 2 points (67% vs. 13%, P<0.005). This difference remained significant after adjustment for confounding variables. When confining analysis to those with idiopathic non-immune hydrops, women in the perinatal non-survivor group had significantly higher USNIH score than those in the perinatal survivor group, and this difference remained significant after adjustment. Conclusions: Our USNIH system may be a reliable predictive marker for perinatal outcomes in cases of non-immune hydrops, especially in idiopathic hydrops during the antenatal period.

Original languageEnglish
Pages (from-to)53-59
Number of pages7
JournalJournal of Perinatal Medicine
Issue number1
Publication statusPublished - 2015 Jan 1

Bibliographical note

Publisher Copyright:
© 2015, Walter de Gruyter GmbH. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology


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