Hydrops fetalis is excessive extravasation of fluid into the third space in a fetus which could be due to heart failure, volume overload, decreased oncotic pressure, or increased vascular permeability. It is considered a prenatal form of cardiac failure. It was traditionally divided into two broad groups:. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait.
|Published (Last):||23 October 2016|
|PDF File Size:||15.30 Mb|
|ePub File Size:||14.52 Mb|
|Price:||Free* [*Free Regsitration Required]|
Hydrops fetalis is a serious condition. It occurs when abnormal amounts of fluid build up in two or more body areas of a fetus or newborn. It is a symptom of underlying problems. There are two types of hydrops fetalis, immune and nonimmune. The type depends on the cause of the abnormal fluid.
The number of babies who develop immune hydrops fetalis has dropped due to a medicine called RhoGAM. This drug is given as an injection to pregnant mothers who are at risk for Rh incompatibility. The drug prevents them from making antibodies against their babies' red blood cells.
There are other, much rarer, blood group incompatibilities that can also cause immune hydrops fetalis, but RhoGAM does not help with these. An amniocentesis and frequent ultrasounds will be done to determine the severity of the condition. Hydrops fetalis often results in death of the infant shortly before or after delivery.
The risk is highest for babies who are born very early or who are ill at birth. Babies who have a structural defect, and those with no identified cause for the hydrops are also at higher risk. Brain damage called kernicterus may occur in the case of Rh incompatibility.
Developmental delays have been seen in babies who received intrauterine transfusions. Immune and nonimmune hydrops fetalis. Fanaroff and Martin's Neonatal-Perinatal Medicine. Philadelphia, PA: Elsevier Saunders; chap Langlois S, Wilson RD. Fetal hydrops. Philadelphia, PA: Elsevier; chap High-risk pregnancies. In: Kliegman RM, St. Nelson Textbook of Pediatrics. Updated by: Neil K. Editorial team. Hydrops fetalis. Immune hydrops fetalis is most often a complication of a severe form of Rh incompatibility , which can be prevented.
This is a condition in which mother who has Rh negative blood type makes antibodies to her baby's Rh positive blood cells, and the antibodies cross the placenta. Rh incompatibility causes a large number of red blood cells in the fetus to be destroyed This is also known as hemolytic disease of the newborn. This leads to problems including total body swelling. Severe swelling can interfere with how the body organs work. Nonimmune hydrops fetalis is more common. The condition occurs when a disease or medical condition affects the body's ability to manage fluid.
There are three main causes for this type, heart or lung problems, severe anemia such as from thalassemia or infections , and genetic or developmental problems, including Turner syndrome. Symptoms depend on the severity of the condition. Mild forms may cause: Liver swelling Change in skin color pallor More severe forms may cause: Breathing problems Bruising or purplish bruise-like spots on the skin Heart failure Severe anemia Severe jaundice Total body swelling.
Exams and Tests. An ultrasound done during pregnancy may show: High levels of amniotic fluid Abnormally large placenta Fluid causing swelling in and around the unborn baby's organs, including the liver, spleen, heart, or lung area An amniocentesis and frequent ultrasounds will be done to determine the severity of the condition.
Treatment depends on the cause. During pregnancy, treatment may include: Medicine to cause early labor and delivery of the baby Early cesarean delivery if condition gets worse Giving blood to the baby while still in the womb intrauterine fetal blood transfusion Treatment for a newborn may include: For immune hydrops, direct transfusion of red blood cells that match the infant's blood type. An exchange transfusion to rid the baby's body of the substances that are destroying the red blood cells is also done.
Removing extra fluid from around the lungs and abdominal organs with a needle. Medicines to control heart failure and help the kidneys remove extra fluids. Methods to help the baby breathe, such as a breathing machine ventilator.
Outlook Prognosis. Possible Complications. Rh incompatibility can be prevented if the mother is given RhoGAM during and after pregnancy. Edema Read more. Fetal Health and Development Read more. Rh Incompatibility Read more.
Hydrops fetalis is a condition in the fetus characterized by an accumulation of fluid, or edema , in at least two fetal compartments. Locations can include the subcutaneous tissue on the scalp , the pleura pleural effusion , the pericardium pericardial effusion and the abdomen ascites. Edema is usually seen in the fetal subcutaneous tissue, sometimes leading to spontaneous abortion. It is a prenatal form of heart failure , in which the heart is unable to satisfy demand in most cases abnormally high for blood flow. Hydrops fetalis usually stems from fetal anemia , when the heart needs to pump a much greater volume of blood to deliver the same amount of oxygen.
2009, Number 6