Among 27 fetuses exhibiting severe sonographic features of nonimmune hydrops fetalis, 33% survived the neonatal period. Nonimmune hydrops fetalis occurs when a disease or medical condition disrupts the bodys ability to manage fluid. Immune hydrops fetalis is a complication of a severe form of rh incompatibility. Improved diagnosis in nonimmune hydrops fetalis using a. It occurs when abnormal amounts of fluid build up in two or more body areas of a fetus or newborn. Nonimmune hydrops fetalis nihf refers specifically to cases of hydrops not caused by red cell alloimmunization. Severe swelling can interfere with how the body organs work and often results. Nonimmune hydrops fetalis nihf is a rare fetal condition with a very high mortality in spite of advances in prenatal diagnostic techniques, early detection, and individualized management. Nonimmune hydrops fetalis nihf develops as a result of one or more nonimmune factors, distinguishing it from immune hydrops fetalis that. Leonecharacterization of newborns with nonimmune hydrops fetalis admitted to. Hydrops fetalis is a serious condition indicating a bad prognosis of affected fetuses. Hydrops fetalis treatment danafarberboston childrens. The documents contained in this web site are presented for information purposes only.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Hydrops fetalis fetal hydrops is a pathologic condition of excessive accumulation of fluid in at. Hydrops fetalis is severe swelling edema in an unborn baby or a newborn baby. The type depends on the cause of the abnormal fluid. In southeast asia, alphathalassemia is the most common cause of hydrops fetalis, accounting for 60 to 90% of cases. Hidropesia fetal no inmune, hydrops fetalis, preclampsia eclampsia, hipoalbuminemia, ane mia, prematurez. Hydrops fetalis fetal hydrops is a serious fetal condition defined as abnormal accumulation of fluid in 2 or more fetal compartments, including ascites, pleural effusion, pericardial effusion, and skin edema. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Erythroblastosis fetalis, or hemolytic disease of the newborn, is a condition caused by specific antibodies of the mother, directed against red cell antigens of the fetus. In previous years, most cases of hydrops were caused by severe erythroblastosis fetalis secondary to rh iso. Outcomes of infants with nonimmune hydrops fetalis born after 22 weeks gestation our experience between 1982 and 2000. Hydrops fetalis hf is defined as the presence of excessive fetal fluid in two or more of the following spaces. Hydrops fetalis is not itself a disease, but an ultrasound marker of other fetal complications. Although hydrops is a fetal condition, in many cases there are associated maternal.
There are two types of hydrops fetalis, immune and nonimmune. Managing non immune hydrops fetalis dr vidya a thobbi professor and head department of obg alameen medical college bijapur 2. Immune hydrops the commonest cause of immune hydrops fetalis is pregnancy in rh negetive women with a rh positive fetus. Nonimmune hydrops fetalis nihf, a form of hf, is a severe fetal condition defined as the excessive. Epidemiology of live born infants with nonimmune hydrops fetalis insights from a populationbased dataset.
Hydrops develops when too much fluid leaves the babys bloodstream and goes into the tissues. Rh negetive mother who is already sensitized by either by a previous pregnancy or blood transfusion, is capable of producing immunogloblin g. The main causes of nonimmune hydrops fetalis are heart or lung problems, severe anemia or genetic or developmental problems. Alloimmunization and nonimmune hydrops fetalis chapter. Nonimmune hydrops fetalis nihf comprises the subgroup of cases not caused by red cell alloimmunization eg, rhd, kell. This type occurs when the baby has a disease or medical condition that disrupts the bodys ability to manage fluids. Ota s, sahara j, mabuchi a, yamamoto r, ishii k, and mitsuda n. These days approximately 90 % of cases of hydrops fetalis are due to nonimmune diseases. Ng zm, seet mj, erng mn, buendia f, chang a, sriram b correspondence. Hydrops fetalis is a serious condition of the fetus or newborn. Rh compatibility causes massive red blood cell destruction, which leads to several problems, including. Although first described in association with immune hydrops, many subsequent case descriptions have been described in the literature secondary to nonimmune hydrops fetalis nihf due to a variety of etiologies. It is a condition where abnormal amounts of fluid build up in two or more body areas causing swelling. To describe the current investigation and management of nonimmune fetal hydrops, with a focus.
With the marked decrease in this condition due to prophylaxis with immune globulin, most cases of hydrops fetalis are now caused by other conditions and are known as nonimmune hydrops. Hydrops fetalis is a serious condition in which abnormal amounts of fluid build up in two or more body areas of a fetus or newborn. About 50% of unborn babies with hydrops dont survive. Castillo ra, devore ld, hadi ha, martin s, geist p. Multiple fetal anatomic and functional disorders can cause nihf. Reported survival rates in nonimmune hydrops fetalis vary considerably. Appropriate investigation and management of nonimmune fetal hydrops. Nonimmune hydrops fetalis nonimmune hydrops fetalis diagnosisdefinition.
Immune hydrops accounts for 1020%of cases maternal antibodies against redcells of the fetus cross the placenta and coat fetal red cells which are then destroyed hemolysis in the. Diagnosis and management nonimmune hydrops inthe newborn. Immune hydrops fetalis is no longer very common due to advances in the prevention of hemolytic disease of the. Hydrops fetalis, characterized by fluid accumulation in fetal tissues and body cavities, is a nonspecific finding appeared in many different ways. Non immune hydrops fetalis accumulation of extracellular fluid in tissues and 2 or more serous cavities without evidence of circulating antibodies against red cell antigens. Nonimmune hydrops fetalis is a serious fetal condition in which abnormal fluid accumulates in at least two different fetal compartments, and in which circulating antibodies against redcell antigens are absent in the mother. The identification of hydrops by ultrasound is very frustrating to the family and physicians because it requires extensive search for the etiology, which include a. Hydrops fetalis definition and meaning collins english. It is not a diagnosis in itself, but a symptom and endstage result of a wide variety of disorders. It may develop because of rh disease in the mother. Hydrops can be divided into two major categories or types.
Examples of conditions that can interfere with the babys fluid management include. Hydrops fetalis genetic and rare diseases information. Immune hydrops fetalis is most often a complication of a severe form of rh incompatibility, which can be prevented. Hydrops fetalis is sometimes used as a synonym for homozygous alpha thalassemia, a lethal or lifethreatening disease of mid and late fetal development caused by. Close this message to accept cookies or find out how to manage your cookie settings. Hydrops fetalis is a descriptive term for generalized edema of the fetus, with fluid accumulation in extravascular components and body cavities. Hydrops fetalis is a pathological condition of excessive fluid accumulation in at least two extravascular compartments, including fetal soft tissues and body cavities. Nonimmune hydrops fetalis nihf is a complex condition with a high mortality and morbidity rate. Incidence of immune hydropsfetalis is significantly decreasing, whereas more and more nonimmune. This is a condition in which mother who has rh negative blood type makes antibodies to her babys rh positive blood cells, and the antibodies cross the placenta.
Seventy percent of all cases of ahf associated with parvo b19 infection occur between 20 and 24 weeks of gestation 11. Hydrops fetalisor hydropsis a condition in which large amounts of fluid build up in a babys tissues and organs, causing extensive swelling edema. Investigation and management of nonimmune fetal hydrops. The aim of this study was to outline the disease etiology in a cohort of fetuses prenatally diagnosed with nonimmune hydrops fetalis nihf. Etiology and outcome of nonimmune hydrops fetalis in southern. Hydrops fetalis, or hydrops, is a condition that occurs when large amounts of fluid build up in a babys tissues and organs causing extreme swelling.
Hydrops occurring in patients with rh incompatibilityinfected rh is called immune hydrops fetalis,however hydrops arising out of fetal or maternal causes. Hydrops fetalis is an excess accumulation of fluid in the fetus. This is me with my son, who is a survivor of hydrops fetalis. Nonimmune hydrops is the presence of two or more abnormal fetal fluid collections in the absence of red cell alloimmunization. Ultrasound evaluation of hydrops fetalis radiology key. Hydrops fetalis refers to abnormal fluid collections in fetal soft tissues and serous cavities.
Nonimmune hydrops fetalis nihf refers to hydrops in the absence of maternal. Hydrops fetalis is a condition in the fetus characterized by an accumulation of fluid, or edema, in at least two fetal compartments. Fahnenstich h, schmid g, kowalewski s, gembruch u and hansmann m 1989. The basic mechanism for the formation of hf is an imbalance between interstitial fluid production and.
In the case of immune hydrops fetalis, a frequent cause is maternofetal incompatibility as in that related to a number of genetic anemias and metabolic. Pdf nonimmune hydrops fetalis nihf is a rare fetal condition with a very high mortality in spite of advances in prenatal diagnostic. In earlier series, no cause was found in approximately 50% of. Nonimmune hydrops fetalis in a childrens hospital singapore. Erythroblastosis fetalis and hydrops fetalis springerlink. Severe fetal anemia and cardiac compromise are important causes of nonimmune hydrops fetalis, and fetal recovery also depends on the degree of fetal heart. 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. Nonimmune hydrops fetalis yurdakok journal of pediatric and. This link is one of the only forums that i can find with open discussion and support on the topic. These fluidfilled spaces can occur in different fetal body locations, including. Introduction we aimed to study the profile of nonimmune hydrops fetalis nihf in the local population and identify its outcomes and causes.
Depending on the severity and cause of hydrops, there may be edema of fetus and placenta, ascites, pleural effusions andor pericardial effusions. These are largely rhd antigens, but rare cases of sensitization against other antigens e. These immunoglobin g igg antibodies cross the placenta and destroy haemolysed. A wide range of associations have been reported in over 500 cases112 but the commonest are chromosomal abnormalities, cardiac anomalies, pulmonary abnormalities, infection andmultiple births. Hydrops fetalis is found in about 1 per 2,000 births and is categorized as immune or nonimmune hydrops. For five of the nine survivors, the prognosis remains uncertain or poor. Perinatal and oneyear outcomes of nonimmune hydrops fetalis by etiology and age at diagnosis. Nonimmune fetal hydrops is a clinical phenotype and not a diagnosis.
Hydrops fetalis is an excessive accumulation of fluid within the fetal extravascular compartments and body cavities generally characterized by. Nonimmune hydrops fetalis accounts for 76 to 87% of all described cases of hydrops fetalis bellini et al. Hidrops fetalis adalah pdf hydrops fetalis is a severe, lifethreatening problem of severe edema swelling in the fetus and newborn. Causes there are two types of hydrops fetalis, immune and nonimmune. Douglas wilson, in fetal medicine third edition, 2020. By comparison, hydrops allantois or hydrops amnion is an accumulation of excessive fluid in the allantoic or amniotic space, respectively. Nonimmune hydrops fetalis is a heterogeneous disorder, caused by a large number of underlying pathologic processes. An external file that holds a picture, illustration, etc.