Nonimmune Hydrops Fetalis

Hydrops fetalis or fetal hydrops is defined as a generalized abnormal accumulation of serous fluid in the entire body including abnormal collection in tissues and body cavities. It is not a specific disease but the end result of many fetal conditions. Presentation may be prenatal with ultrasound diagnosis on at the time of delivery. There are many causes of fetal hydrops including cardiac, pulmonary, chromosomal, hematologic, and metabolic. The mortality rate is high, with the best survival in those infants who have cardiac rhythm abnormalities. Proper assessment of the infant with hydrops requires familiarity with the major causes and a stepwise protocol for investigation. Not only are the usual blood-grouping studies important, but also chromosomal analysis, metabolic screening, and carefully performed autopsy. The aim of the protocol that is suggested is to improve intrauterine detection and survival after birth and to ascertain the cause of the condition to aid in counseling and care in subsequent pregnancies.

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Congenital Gastric Outlet Obstruction and Nonimmune Hydrops Fetalis: A Prenatal Sonographic Diagnosis of a Case with Hydrothorax and Ascites

The Scientific World JOURNAL ◽

10.1100/tsw.2008.114 ◽

2008 ◽

Vol 8 ◽

pp. 929-933

Author(s):

A. Yisau Abdulkadir ◽

O. A. M. Adesiyun ◽

A. Adisa Fawole ◽

A. Peter Aboyeji

Keyword(s):

Gastric Outlet Obstruction ◽

Outlet Obstruction ◽

Clinical History ◽

Fetal Outcome ◽

Hydrops Fetalis ◽

Male Fetus ◽

Fetal Hydrops ◽

Sonographic Diagnosis ◽

Massive Pleural Effusion ◽

Nonimmune Hydrops

A case of a male fetus with sonographic diagnosis of hydrops fetalis at 19-week gestation is reported. The fetus had anasarca, bilateral massive pleural effusion, and ascites, in addition to cardiac arrhythmia and congenital gastric outlet obstruction. Mother's clinical history and laboratory workup excluded immune hydrops. The etiological dilemma and fetal outcome are discussed. We concluded, based on this case, that when fetal hydrops occurs early and is associated with multiple congenital anomalies, prolonging the pregnancy may be futile.

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Characterization of newborns with nonimmune hydrops fetalis admitted to a neonatal intensive care unit

Revista do Hospital das Clínicas ◽

10.1590/s0041-87812003000300001 ◽

2003 ◽

Vol 58 (3) ◽

pp. 125-132 ◽

Cited By ~ 17

Author(s):

Renata Suman Mascaretti ◽

Mário Cícero Falcão ◽

Andrea M. Silva ◽

Flávio Adolfo Costa Vaz ◽

Cléa Rodrigues Leone

Keyword(s):

Mortality Rate ◽

Hospital Stay ◽

Gestational Age ◽

Perinatal Asphyxia ◽

Length Of Hospital Stay ◽

Hydrops Fetalis ◽

Large For Gestational Age ◽

Laboratory Evaluation ◽

Average Weight ◽

Nonimmune Hydrops

PURPOSE: To determine the incidence and characteristics of nonimmune hydrops fetalis in the newborn population. METHOD: A retrospective study of the period between 1996 and 2000, including all newborns with a prenatal or early neonatal diagnosis of nonimmune hydrops fetalis, based on clinical history, physical examination, and laboratory evaluation. The following were analyzed: prenatal follow-up, delivery type, gender, birth weight, gestational age, presence of perinatal asphyxia, nutritional classification, etiopathic diagnosis, length of hospital stay, mortality, and age at death. RESULTS: A total of 47 newborns with hydrops fetalis (0.42% of live births), 18 (38.3%) with the immune form and 29 (61.7%) with the nonimmune form, were selected for study. The incidence of nonimmune hydrops fetalis was 1 per 414 neonates. Data was obtained from 21 newborns, with the following characteristics: 19 (90.5%) were suspected from prenatal diagnosis, 18 (85.7%) were born by cesarean delivery, 15 (71.4%) were female, and 10 (47.6%) were asphyxiated. The average weight was 2665.9 g, and the average gestational age was 35 3/7 weeks; 14 (66.6%) were preterm; 18 (85.0 %) appropriate delivery time; and 3 (14.3%) were large for gestational age. The etiopathic diagnosis was determined for 62%, which included cardiovascular (19.0%), infectious (9.5%), placental (4.8%), hematologic (4.7%), genitourinary (4.8%), and tumoral causes (4.8%), and there was a combination of causes in 9.5%. The etiology was classified as idiopathic in 38%. The length of hospital stay was 26.6 ± 23.6 days, and the mortality rate was 52.4%. CONCLUSIONS: The establishment of a suitable etiopathic diagnosis associated with prenatal detection of nonimmune hydrops fetalis can be an important step in reducing the neonatal mortality rate from this condition.

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