NPPB and hydrops fetalis: However, given the strong evidence for naturietic peptides in prognosis in heart failure (56) BNP/NT-proBNP is in the 2017 ACC/AHA Heart Failure guideline for risk stratification in a pre-clinical population to identify those at risk for HF “Stage A/B” for prevention (COR IIa) (before the onset of clinical HF), besides being a measure to guide prognosis and further risk stratification in those with HF (57).