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Non-Immune Hydrops Fetalis
Non-Immune Fetal Oedema

Presentation

Abstract This article reviews the various aspects of non-immune hydrops fetalis, including the historical background, aetiology, clinical presentation, antenatal diagnosis and perinatal management, as well as presenting some data on cases of non-immune [ncbi.nlm.nih.gov]

The presentations are ascites, scalp edema, pleural effusions, pericardial effusions leading to anasarca and polyhydramnios [1]. [semanticscholar.org]

Entire Body System

  • Trisomy 21

    Trisomy 21 (47,XY,+21) was subsequently confirmed following chromosomal evaluation. [hkmj.org]

    trisomy 13 trisomy 18 trisomy 21 cardiac causes abnormalities in fetal heart rate: e.g. fetal tachyarrhythmias congenital cardiac anomalies fetal cardiac tumors: cardiac rhabdomyoma twin pregnancy-related complications twin to twin transfusion syndrome [radiopaedia.org]

    Second most common cause is chromosomal anomalies such as Turners-45X (42%), Trisomy-21(34%) Trisomy-18(9%), other trisomies such as Trisomy 13, 15 and 162 as well as Tetraploidy. [keralamedicaljournal.com]

    Trisomies 21, 18, 13, other very rare trisomies, and tetraploidy/triploidy are associated with most of the remainder. [exxcellence.org]

    25294712 ) Turgal M....Sinan Beksac M. 2014 14 Accessory diaphragm associated with non-immune hydrops fetalis. ( 25100808 ) Priyadarshi A....Bolisetty S. 2014 15 Transient myeloproliferative disorder and non-immune hydrops fetalis in a neonate with trisomy [malacards.org]

Respiratoric

  • Aspiration

    Abstract The level of pituitary hormones was measured in the serum and cysts' aspirate in a case of hyperreactio luteinalis (HL) complicating non-immune hydrops fetalis. [ncbi.nlm.nih.gov]

    Since definite diagnosis of HLH was made with post-mortem BM and spleen aspirates, he was not administered chemotherapy. Discussion In this study, we report nonimmune hydrops fetalis in two cases owing to very rare and different diseases. [nature.com]

    Intrauterine hypoxia Infant respiratory distress syndrome Transient tachypnea of the newborn Meconium aspiration syndrome pleural disease Pneumothorax Pneumomediastinum Wilson—Mikity syndrome Bronchopulmonary dysplasia. [cardloan-sinsa.site]

    A hematocrit of less than 30% is an indication for transfusion. [3] Antenatal surgical interventions include: Needle aspiration, feto-amniotic shunting, open fetal surgery, and fetal endoscopic surgery. [jmedsoc.org]

    Interventions performed include: Needle aspiration Feto-amniotic shunting repair of congenital diaphragmatic hernia, resection of cystadenomatoid malformation of the lung, and excision of large sacrococcygeal teratomas. [slideshare.net]

  • Tachypnea

    Intrauterine hypoxia Infant respiratory distress syndrome Transient tachypnea of the newborn Meconium aspiration syndrome pleural disease Pneumothorax Pneumomediastinum Wilson—Mikity syndrome Bronchopulmonary dysplasia. [cardloan-sinsa.site]

    The chest examination showed tachypnea but no crepitations; he was also tachycardic with first and second heart sounds, but no murmur. [mmj.eg.net]

Liver, Gall & Pancreas

  • Neonatal Jaundice

    After the baby is born, the signs of hydrops can include: Pale complexion Severe swelling, especially in the abdomen Breathing difficulty Enlarged spleen and liver Severe neonatal jaundice The appearance of bruises on the skin Complications of Hydrops [pregnancycorner.com]

    […] spleen enlargement Severe swelling or edema in different parts, especially the abdomen Difficulty breathing Neonatal jaundice Neonatal anemia Heart failure [10] Hydrops Fetalis Prevention Immune fetal hydrops has become quite rare with the advancement [pregmed.org]

Cardiovascular

  • Hypertension

    Idiopathic hypertension. Fetal Changes :- 1. Hydrops fetalis. 2. Cystic Hygroma. 3. Single Umbilical artery. 4. I.U.G.R. 5. Congenital Heart Defects. Adult Turner?Syndrome with additional features :- 1. Hypertension. 2. Diabetes Mellitus. 3. [jalananil.tripod.com]

    She has no history indicative of TB, jaundice, malaria, HIV, hypertension or heart diseases. She has no surgical history. Both her parents are diabetic. She has normal menstrual history. [jemds.com]

    Mothers may develop massive anasarca, hypertension, and proteinuria (mirror syndrome). Death of fetus is usually due to heart failure and hypoxia. [orpha.net]

    Increased red blood cell production by the spleen and liver leads to hepatic circulatory obstruction (portal hypertension) Anti-D, anti-E, and antibodies directed against other Rh antigens comprise the majority of antibodies responsible for hemolytic [perinatology.com]

    Mirror syndrome may represent a form of preeclampsia, and is characterized by edema in approximately 90 percent, hypertension in 60 percent, and proteinuria in 40 percent of cases. [smfm.org]

  • Thrombosis

    congenital nephrosis) and teratomas, skeletal malformations (achondroplasia, osteogenesis imperfecta, fetal neuroblastomatosis, storage disease, meconium peritonitis, idiopathic) • Placental Chorangioma, umbilical or chorionic vein thrombosis • Maternal [medical-dictionary.thefreedictionary.com]

    Neonatal disseminated intravascular coagulation after thrombosis of a fetal intra-abdominal umbilical vein varix. J Obstet Gynaecol 2010;30:315. 8. De Catte L, Osmanagaoglu K, De Schrijver I. [synapse.koreamed.org]

    […] hydrops fetalis syndrome) 8,13 cause of alpha thalassemia relatively common cause in Southeast Asia fetal skeletal dysplasia(s) 10 fetal lymphovascular anomalies cystic hygroma 8 high output flow states vein of Galen aneurysmal malformation umbilical vein thrombosis [radiopaedia.org]

    Other Retroperitoneal fibrosis Skeletal Osteogenesis imperfecta Asphyxiating thoracic dystrophy Thanatophoric dwarfism Achondrogenesis Hyperphosphatasia Saldino-Noonan dwarfism Tumours Teratoma Neuroblastoma Haemangioma Placental/Umbilical True knot UV thrombosis [adhb.govt.nz]

    […] bronchopulmonary sequestration, congenital diaphragmatic hernia (CDH), esophageal atresia, midgut volvulus, meconium peritonitis, duodenal diverticulum, intestinal duplication, malrotation, imperforate anus, hypoplastic kidneys, polycystic kidneys, renal vein thrombosis [jmedsoc.org]

  • Heart Disease

    Two patients received digitalis transplacentally for treatment of congestive heart failure secondary to congenital heart disease without response. [ncbi.nlm.nih.gov]

    Moss and Adams' Heart Disease in Infants, Children and Adolescents Including the Fetus and Young Adult. ‎ Seite 301 - Landon MB, Mintz MC, Gabbe SG. [books.google.de]

    She has no history indicative of TB, jaundice, malaria, HIV, hypertension or heart diseases. She has no surgical history. Both her parents are diabetic. She has normal menstrual history. [jemds.com]

    See Hemolytic disease of the newborn. [medical-dictionary.thefreedictionary.com]

    The diagnosis of cyanotic congenital heart disease was, however, considered. Figure 1: Generalized edema, abdominal swelling, and generalized bluish discoloration. [mmj.eg.net]

Neurologic

  • Seizure

    Babies born with hydrops fetalis may also have underdeveloped lungs and be at a higher risk of: heart failure brain damage hypoglycemia seizures [healthline.com]

    If the baby does survive, he or she is at risk for a type of brain damage called kernicterus, which leads to mental disability and a tendency toward seizures and motor control problems. [pregnancycorner.com]

    Hypoglycemia (low blood sugars) put these babies at risk for seizures, apnea (difficulty breathing) and possible brain injury. [chw.org]

    Lymphoproliferative Syndrome Type IV, Schimmelpenning– Feuerstein-Mims Syndrome, Noonan Syndrome AD 100 15 of 15 PIEZO1 Dehydrated Hereditary Stomatocytosis, Hereditary Lymphedema AD,AR 99.98 107 of 107 PIGA Multiple Congenital Anomalies- Hypotonia-Seizures [igenomix.es]

  • Intracranial Hemorrhage

    Fetal anemias which lead to hydrops can also result from fetal hemorrhage (such as intracranial bleeding from arterio-venous malformation or sacrococcygeal teratoma), fetal-maternal hemorrhage (such as from abruptio or from placental tumours such as chorioangioma [slideshare.net]

Workup

[…] genetic physician or genetic counselor who will be evaluating your family health history for possible inheritable conditions that would cause hydrops Any other specialists as necessary to address underlying issues or abnormalities uncovered by the overall workup [chw.org]

Extensive clinical workup is required to attempt to identify the specific etiology. In patients in whom NIHF is suspected, the search for a cause starts with a maternal evaluation. [slideshare.net]

Treatment

The survival rate in the intrauterine treatment group was higher than in the nontreatment group (treatment group: 10/15; non-treatment group: 5/34, p < 0.001). [ncbi.nlm.nih.gov]

Management and treatment Treatment depends on the cause. Intrauterine treatment can involve thoraco-amniotic drainage, antiarrhythmic drugs (digoxin, sotalol, propranolol) and blood transfusion when anemia is present. [orpha.net]

Treatment and Handling: The basic rule in the treatment of fetal hydrops is the early diagnosis and the treatment of the underlying etiological factors. · The first steps needed to be taken after the detection of hydropic fetus are the maternal complete [tibbiyardim.com]

Prognosis

AIM: The prognosis for non-immune hydrops fetalis (NIHF) is still poor despite progress in perinatal care. [ncbi.nlm.nih.gov]

Prognosis and Outcomes: The prognosis depends on etiology, response to therapy if treatable, and on the gestational age at detection and delivery. [smfm.org]

Etiology

The gestational age at diagnosis, etiology, perinatal outcome, and 1-year outcome were recorded, and their associations assessed. [ncbi.nlm.nih.gov]

Epidemiology

First, we performed epidemiological studies to determine the critical period during which maternal infection led to hydrops fetalis. [jstage.jst.go.jp]

Summary Epidemiology The prevalence of NIHF is unknown as it is difficult to obtain when many cases are not diagnosed before intrauterine death or may spontaneously resolve antenatally. Currently, NIHF constitutes up to 90% of all HF cases. [orpha.net]

Congenital cytomegalovirus infection: review of the epidemiology and outcome. Obstet Gynecol Surv. 2002; 57 :245–256. [ PubMed ] [ Google Scholar ] 8. Fowler KB, Stagno S, Pass RF. [ncbi.nlm.nih.gov]

Diagnosis/definition: Non-immune hydrops is the presence of two or more abnormal fetal fluid collections in the absence of red cell alloimmunization. ( Figure 1 ).Epidemiology/Incidence: Non-immune hydrops fetalis (NIHF) refers specifically to cases of [smfm.org]

[Source] Pediatric Hydrops Fetalis: Background, Pathophysiology, Epidemiology. 2016 Mar 24 [cited 2016 Apr 29]. [Source] Hydrops fetalis. In: Wikipedia, the free encyclopedia [Internet]. 2016 [cited 2016 Apr 29]. [keralamedicaljournal.com]

Pathophysiology

The exact pathophysiology is still poorly understood. It is important to detect NIHF early, diagnose the underlying cause and institute appropriate treatment. There is need for autopsy of all fetuses or neonates who die from NIHF. [ncbi.nlm.nih.gov]

Non-immune hydrops fetalis: a short review of etiology and pathophysiology. Am J Med Genet A. 2012;158A:597–605. CrossRef PubMed Google Scholar 2. Randenberg AL. Nonimmune hydrops fetalis part I: etiology and pathophysiology. [link.springer.com]

General Pathophysiology Fluid accumulates within … View Full Text Log in using your username and password Log in through your institution You may be able to gain access using your login credentials for your institution. [neoreviews.aappublications.org]

Key words: Hydrops Fetalis, Fetal Tachyarrhythmia, Cardiovascular Profile Score Advertisement Journal of Molecular Pathophysiology SUBMIT YOUR ARTICLE NOW [scopemed.org]

Evidence of endothelium involvement in the pathophysiology of hydrops fetalis? Early Hum Dev 2000;57:205-9. Crossref [hkmj.org]

Prevention

We suggest that an effective thalassemia-screening program for prevention and control of homozygous alpha-thalassemia-1 be established in all areas where the alpha-thalassemia-1 gene is prevalent. Copyright (c) 2005 S. Karger AG, Basel. [ncbi.nlm.nih.gov]

Fetal anemia and hydrops due to intrauterine fetal blood transfusion can be prevented. [tibbiyardim.com]

Prevention Rh incompatibility can be prevented if the mother is given RhoGAM during and after pregnancy. References Carlo WA, Ambalavanan N. High-risk pregnancies. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. [mountsinai.org]

Immune hydrops fetalis is most often a complication of a severe form of Rh incompatibility, which can be prevented. [medlineplus.gov]

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2.1
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