Fetal complications

Question 1

Hydrops - non-immune - causes

Answer 1

Abnormal accumulation of fluid in 2 or more fetal compartments (out of 4)

10% Immune (due to Rh alloimmunisation), 90% non-immune

CAUSTIC = mnemonic for non-immune causes (Cardiovascular, Anaemia, Unexplained/Idiopathic, Structural, Twins, Infection, Chromosomal)

Question 2

Hydrops - ultrasound features

Answer 2

Pleural effusion, pericardial effusion, ascites, subcutaneous/skin oedema “anasarca” + placentomegaly/placental thickening, polyhydramnios also often present

Question 3

Hydrops - prognosis

Answer 3

Prognosis depends on aetiology, GA at onset, GA at delivery, presence of pleural effusions
* Pleural effusion or polyhydramnios < 20 weeks = usually poor (pulmonary hypoplasia + increased risk PPROM, PTB)
* Absence of aneuploidy and major structural anomalies confer better prognosis
* Rh disease usually do well

Question 4

FGR
Dopplers