Hydrops Fetalis Flashcards
Hydrops Fetalis
Prevalence: 1 in 2,000 births.
Ultrasound: Abnormal accumulation of serous fluid in at least two of the following: skin (edema) and body cavities (pericardial, pleural, or ascitic effusions).
Placentomegaly (placental thickness >6 cm) is often present.
Aetiology: Non-specific finding in a wide variety of fetal and maternal disorders, including hematological, chromosomal, cardiovascular, renal, pulmonary, gastrointestinal, hepatic and metabolic abnormalities, congenital infection, neoplasms, malformations of the placenta or umbilical cord and genetic syndromes.
Classically divided into:
Immune: 10% of cases and it is due to maternal hemolytic antibodies.
Non-immune: 90% of cases and it is due to all other etiologies.
Follow up: Scans every 2-3 weeks to monitor the evolution of hydrops.
There is a risk of maternal morbidity due to the ‘mirror syndrome’ (combination of fetal hydrops with generalized fluid overload and a preeclamptic state in the mother).
Prognosis: Depends on the cause of hydrops.
Progressive unexplained hydrops is often lethal before or soon after birth.
Recurrence: Fetal defects, infection: no increased risk of recurrence.
Part of trisomies: 1%.
Red blood cell isoimmunisation: high.
Metabolic disorders: 25%.
