fetal hydrops

Question 1

Fetal hydrops?

Answer 1

accumulation of
edema fluid in the
fetus in 2 or more compartments during
intrauterine growth

Question 2

What causes Rh incompatibility between mother and fetus?

Answer 2

D antigen

Question 3

What are the 4 ways in which Immune hydrops occur?

Answer 3

1-blood group (ABO) incompatibility b/w mother and fetus
2-Antibody induced hemolytic disease
3-paternal(father) inherited red blood cell antigenic markers (foreign to mother)
4-Rh(D antigen) and ABO blood group antigens

Question 4

How can the fetal red blood cells reach the mother?

Answer 4

-during the last trimester of pregnancy(trophoblastic barrier is not present)

-during childbirth (feto-maternal bleeding)

Question 5

What can Hemolysis of fetus’ RBC cause?

Answer 5

-anemia
-ischemia
-intrauterine heart failure
-EDEMA(fetal hydrops)

Question 6

What can be done to an Rh-negative mother who has given birth to Rh-positive baby to prevent hemolysis?

Answer 6

1-administration of Rh Ig to the mother at 28
wks postpartum and within 72 hours.

2-RhIg masks antigenic sites on RBC that have leaked into the maternal circulation

3-Result: preventing long-term sensitization to Rh antigen.

Question 7

In which case does Feto-maternal ABO incompatibility occurs?

Answer 7

When the infant’s blood group is A or B and the mother is O (O blood group can only receive O type)

Question 8

What are the etiological causes of non-immune Hydrops?

Answer 8

-Cardiovascular defects
-chromosomal abnormalities
-fetal anemia
-transplacental infection with Parvovirus B19

Question 9

What are the clinical manifestations that indicate Hydrops + fetal anemia?

Answer 9

-fetus and placenta are pale

-enlargement of liver and spleen

-bone marrow shows hyperplasia of erythroid precursors(meaning increased RBC precursors ,EXCEPTION: parvovirus infections have APLASTIC ANEMIA[damage to bone marrow stem cells)

-extramedullary hematopoiesis(formation of blood)(in liver, spleen,kidneys,lungs,lymph nodes, &heart)

Question 10

Hemolysis—>……….—>unconjugated bilirubin reaches CNS—>………….

Answer 10

Hemolysis—>hyperbilirubinemia—> unconjugated bilirubin reaches CNS—> Brain damage(kernicterus)

Question 11

Bilirubin accumulation in the basal ganglia and brain stem is known as ………?

Answer 11

Kernicterus

Question 12

What are the clinical manifestations that indicate Immune hydrops?

Answer 12

-high titers of Rh Ab in mother ***

Question 13

What are the sites in the fetus where hydrops occur?

Answer 13

Accumulation of fluid occurs at the following sites:
-scalp
-pericardial effusion(heart)
-pleural effusion(lung)
-Ascites (abdomen)
-Skin