UW hydrops fetalis 02-17 (1)

Question 1

UW. fetal hydrops table. patogenesis 2?

Answer 1

incr. CO demand causing heart failure
incr. fluid movement into interstitial spaces (third spacing)

Question 2

UW. fetal hydrops table. clinical features?

Answer 2

pericardial effusion
pleural effusion
ascites
skin edema
placental edema
polyhydramnios

Question 3

UW. fetal hydrops table. etiology. Immune?1

Answer 3

RhD alloimmunization

Question 4

UW. fetal hydrops table. etiology. nonimmune?4

Answer 4

parvovirus B19 infection
Fetal aneuploidy
cardiovascular abnormalities
Thalassemia (eg hemoglobin Barts)

Question 5

UW. fetal hydrops. sequela of high-output fetal heart failure characterized by excessive fluid accumulation in interstitial spaces.

Answer 5

.

Question 6

UW. fetal hydrops. MCC infection?

Answer 6

maternal parvovirus B19 infection

Question 7

UW. fetal hydrops. parvovirus 19 mechanism?

Answer 7

Most adults with parvovirus B19 infection are asymptomatic; however, parvovirus B19 during pregnancy can have devastating fetal consequences due to viral cytotoxicity to fetal erythrocyte precursors.
With increasingly severe fetal anemia, the fetal heart tries to compensate for hypoxemia by increasing cardiac output. However, eventually it cannot compensate, and high-output fetal heart failure develops. As with other cases of heart failure, fetuses develop third spacing of fluid, resulting in ascites (ie, tense fluid-filled abdomen) and generalized skin edema (and subsequent peeling). Other clinical features include pleural or pericardial effusions and placental edema.

Question 8

UW. fetal hydrops. these fetuses are at incr. risk for what?

Answer 8

Fetuses with hydrops fetalis are at high risk for fetal demise; this risk increases with infection acquired at earlier gestational ages.
Due to this risk, patients with fetal hydrops undergo serial ultrasounds and possible early delivery.

Question 9

UW. fetal hydrops. patients with this risk what should undergo? 2

Answer 9

Due to this risk, patients with fetal hydrops undergo serial ultrasounds and possible early delivery.

Question 10

UW. congenital hypothyroidism. what presentation simmilar to hydrops fetalis?

Answer 10

Congenital hypothyroidism can cause swollen, edematous skin (ie, myxedema) due to glycosaminoglycan deposits in the dermis.
However, it does not cause ascites or placental edema, making this diagnosis unlikely.

Question 11

UW. parvovirus is not assoc. with what system pathologies?

Answer 11

Parvovirus B19 infection is not associated with bony or facial dysmorphic features.

Question 12

UW. Both fetal aneuploidy (eg, trisomy 18) and fetal alcohol spectrum disorder (ie, chronic maternal alcohol use) can have associated …… what system?

Answer 12

can have associated congenital cardiac defects (eg, atrioventricular septal defect) that can lead to heart failure and hydrops fetalis.

Question 13

UW. Both fetal aneuploidy (eg, trisomy 18) and fetal alcohol spectrum disorder - what symptoms have fetuses that do not have fetal hydrops due to parvovirus?

Answer 13

However, these fetuses are typically growth-restricted and have limb abnormalities (eg, shortened long bones, clubfoot) or dysmorphic facial features (eg, hypoplastic midface, flattened nasal bridge).

Question 14

UW case. 37yo + 24 weeks + delivers male fetus with no cardiac activity. fetus is edematous peeling skin, tense fluid filled fetal abdomen + thick edematous placenta. maternal blood type O Rh negative –> antibodies also negative.
Cause of hydrops fetalis?

Answer 14

Parvovirus 19 infections.

Question 15

24F + g. 2 p. 0 aborta 1, at 26 weeks gestation + initial prenatal visit.
Previous pregnancy was a spontaneous abortion at 8 weeks gestation.
Fundal height is 32 cm. Maternal blood type is O, Rh negative. Indirect Coombs test is negative. Normal BP, HR.
Was in EM due to 2 days of persistent vomiting.
Transabdominal UG: female fetus with a biparietal diameter and head circumference that are consistent with 26 weeks gestation.
Abdominal circumference measures at 34 weeks gestation. Fetal heart rate is 180/min. A pericardial effusion, bilateral pleural effusions, and polyhydramnios are noted in the fetus.
CAUSE?

Answer 15

EXPOSURE TO CHILD WITH A SLAPPED-CHEEK RASH

Question 16

UW. parvovirus 19 symptoms in ADULTS? if symptomatic

Answer 16

Parvovirus B19 infection in adults can be asymptomatic OR associated with nonspecific flulike symptoms or arthralgias;

Question 17

UW. parvovirus 19 symptoms in kids? symptoms

Answer 17

typically presents with a slapped-cheek rash that follows nonspecific prodromal symptoms (corresponding with viremia).

Question 18

UW. parvovirus 19 spread?

Answer 18

The virus is transmitted via respiratory droplets

Question 19

UW. parvovirus 19. Pregnant women should avoid infected individuals because the virus can cross the placenta and have devastating fetal consequences.

Answer 19

.