What is fetal hydrops

Our Thalassemia Program cares for children with hydrops fetalis. For Patients. Hydrops Fetalis. Contact the Thalassemia Program Email hemeclinic-dl childrens. Learn More. What is hydrops fetalis? What are the symptoms of hydrops fetalis? Many different diseases and other medical complications can cause hydrops fetalis, such as: hemolytic disease of the newborn severe anemia infections present at birth heart or lung defects chromosomal abnormalities and birth defects liver disease How is hydrops fetalis diagnosed?

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. Centers with expertise in fetal treatment can provide recommendations about fetal interventions if appropriate. For example, in cases of a very large fluid collection around the fetal lungs pleural effusion , consideration may be given to placement of a shunt in utero to drain the fluid collection.

Pregnant women should be monitored very closely throughout a pregnancy with NIHF, as there is risk of developing a condition called maternal mirror syndrome a form of preeclampsia. Blood pressure should be checked frequently, along with lab work. If maternal mirror syndrome develops, delivery becomes indicated for the safety of the mother and fetus. Approximately two thirds of pregnancies with NIHF are delivered preterm before 37 weeks gestation.

Corticosteroids are often recommended to decrease the risk of neonatal respiratory distress and other complications if concern arises for a preterm delivery. However, in the absence of spontaneous preterm labor, maternal illness, significantly worsened NIHF, or other complicating factors, current recommendations are to aim for a term delivery to minimize the additional risks of prematurity.

Antenatal testing also called non-stress testing is usually started in the third trimester, to monitor the well-being of the fetus in utero. Serial ultrasounds to assess fetal growth, the abnormal fluid collections, and other parameters are also recommended. Delivery should be planned at a tertiary care center with access to high risk obstetricians, neonatologists, and other specialists important for care of the neonate after birth.

Prognosis for neonates born with NIHF varies widely by the underlying cause, as well as with gestational age at delivery, extent of resuscitation at delivery, and need for transport to a higher level center.

When the prognosis is felt to be extremely poor with very little to no chance of survival, providers may discuss the option of comfort care meaning less interventions with families. Counseling about recurrence risk for NIHF in a future pregnancy is largely dependent on understanding why it happened in the first place.

For cases thought to result from a viral infection, the recurrence risk is likely to be very small. Learn More.