Non-immune Hydrops Fetalis 2023 TOG

Question 1

What USS features are diagnostic of HF?

Answer 1

pericardial effusion, pleural effusion , ascites, skin oedema

Question 2

Which USS features may be seen but not diagnostic

Answer 2

Placentomegaly +/- polyhydramnios

Question 3

What proportion of HF is caused by Non-immune causes?

Answer 3

• Now with Anti-D NIFH >90% of HF cases

Question 4

How common is non-immune Hydrops Fetalis?
Mortality rate

Answer 4

1/2000 pregnancies
60%

Question 5

What proportion of cases of non-immune hydrops is a cause found AN?

Answer 5

60%

Question 6

What is most common cause of non-immune HF throughout pregnancy?

Answer 6

Fetal genetic disorders (chromosomal or monogenic)

Question 7

Most common causes of non immune HF in 1st trimester?

Answer 7

70% chromosomal abnormality
10% cardiac abnormality
5% Extra-cardiac/infections

Question 8

Ix offered in 1st trimester

Answer 8

USS
Fetal ECHO
+/- invasive testing

Question 9

If NIHF <14 weeks what proportion miscarriage/IUD

Answer 9

2/3
TOP offered

Question 10

HF in 2nd/3rd trimester classified into which 3 mains groups?

Answer 10

Immune anaemia
Non-immune anaemia
Non-immune, non-aneamia

Question 11

How is fetal anaemia assessment

Answer 11

MCA doppler, MCA PSV >1.5

Question 12

If anaemia confirmed what Tx can be offered

Answer 12

In-utreo transfusion
Assess for immune cause (red cell antibodies)

Question 13

If non anaemic cause what further testing?

Answer 13

Invasive amntiocentesis
Infection screen
Condor clinical genetics

Question 14

Maternal complications from HF

Answer 14

Polyhydarmnios and PTB
Maternal mirror syndrome