Hydrops fetalis
Background
- Accumulation of edema in at least two fetal compartments
- Usually stems from fetal anemia
- Immune vs Non-Immune
Clinical Features
- Occurs during gestation, may be maternally asymptomatic or present as spontaneous abortion, or patient (mother) may have sings/symptoms of pathology that caused hydrops
- Fetal/neonatal edema is typically located in:
- Subcutaneous tissue/scalp
- Pleura (pleural effusion)
- Pericardium (pericardial effusion)
- Abdomen (ascites)
Complications
- Spontaneous abortions
- Poor fetal outcomes
Causes
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
- Syphilis
Evaluation
- Ultrasound screening
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.