Hydrops fetalis

Background

  • Accumulation of edema in at least two fetal compartments
  • Usually stems from fetal anemia
  • Immune vs Non-Immune

Clinical Features

  • Edema is typically located in:
    • Subcutaneous tissue/scalp
    • Pleura (pleural effusion)
    • Pericardium (pericardial effusion)
    • Abdomen (ascites)

Immune

  • Rh disease
    • RhD-negative mothers during pregnancy and/or within 72 hours of the delivery OR vaginal bleeding
    • Prevention with administration of anti-D IgG (Rho(D) Immune Globulin) injections

Non-Immune

  • Iron Deficiency Anemia
  • Parvovirus B19 (Fifth's Disease)
  • CMV
  • Maternal Syphilis

Evaluation

  • Ultrasound screening

Complications

  • Spontaneous Abortions
  • Poor Fetal Outcomes

Management

  • OBGYN Consultation/Referral
  • Rh Status
  • Iron for all pregnant women

Also See

References

  • Uptodate
  • Bellini C, Hennekam RC. Non-immune hydrops fetalis: a short review of etiology and pathophysiology. Am J Med Genet A 2012; 158A:597.
  • Haile-Mariam T, Polis MA: Viral Illnesses, in Marx JA, Hockberger RS, Walls RM, et al (eds): Emergency Medicine: Concepts and Clinical Practice, ed. 7. St. Louis, Mosby, Inc., 2010, (Ch) 128: p.1712.