Hydrops fetalis
| Hydrops fetalis | |
|---|---|
| Classification and external resources | |
 An ultrasound featuring a baby with Hydrops fetalis |
|
| ICD-10 | P56, P83.2 |
| ICD-9 | 773.3, 778.0 |
| DiseasesDB | 29715 |
| MedlinePlus | 007308 |
| eMedicine | ped/1042 |
| MeSH | D015160 |
Hydrops fetalis is a condition in the fetus characterized by an accumulation of fluid, or edema, in at least two fetal compartments.[1] By comparison, hydrops allantois or hydrops amnion are an accumulation of excessive fluid in the allantoic or amniotic space respectively.[2]
Contents |
Presentation [edit]
Locations can include:
- subcutaneous tissue/scalp
- pleura (pleural effusion)
- pericardium (pericardial effusion)
- abdomen (ascites)
The 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 its demand for a high amount of blood flow.
Classification and causes [edit]
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. This anemia can have either an immune or non-immune cause. Non-immune hydrops can also be unrelated to anemia, for example if a tumor or congenital cystic adenomatoid malformation increases the demand for blood flow.[citation needed] The increased demand for cardiac output leads to heart failure, and corresponding edema.
Immune causes [edit]
- Rh disease is a cause for immune mediated hydrops fetalis; however, owing to preventative methods developed in the 1970s Rh disease has markedly declined. Rh disease can be prevented by administration of anti-D IgG (Rho(D) Immune Globulin) injections to RhD-negative mothers during pregnancy and/or within 72 hours of the delivery. However a small percentage of pregnant mothers are still susceptible to Rh disease even after having been administered anti-D IgG (Rho(D) Immune Globulin)
Non-Immune causes [edit]
The non-immune form of hydrops fetalis has many causes including:
- Iron deficiency anemia
- Paroxysmal supraventricular tachycardia resulting in heart failure
- Deficiency of the enzyme beta-glucuronidase. This enzyme deficiency is the cause of the lysosomal storage disease called Mucopolysaccharidosis Type VII.
- Congenital disorders of glycosylation
- Parvovirus B19 (Fifth Disease) infection of the pregnant woman.
- Cytomegalovirus in mother.
- Maternal syphilis and maternal diabetes mellitus
- α thalassemia can also cause hydrops fetalis when all four of the genetic loci for α globin are deleted or affected by mutation. This is termed Hb Barts (consists of y-4 tetramers).
- Uncommonly, Niemann-Pick Disease Type C (NPC) and Gaucher Disease type 2 can present with hydrops fetalis.
- Turner Syndrome
- Tumors,[3] the most common type of fetal tumor being teratoma, particularly a sacrococcygeal teratoma.
- Twin-twin transfusion syndrome in monochorionic pregnancy (hydrops affects the recipient twin)
- Maternal hyperthyroidism
- fetal cardiac defects and skeletal defects
Diagnosis [edit]
Hydrops fetalis can be diagnosed and monitored by ultrasound scans. Prenatal ultrasound scanning enables early recognition of hydrops fetalis and has been enhanced with the introduction of MCA Doppler.
Treatment [edit]
![[icon]](/wiki/File:Wiki_letter_w_cropped.svg){kind=small} |
This section requires expansion. (August 2010) |
The treatment depends on the cause.
Severely anemic fetuses can be treated with blood transfusions while still in the womb.
See also [edit]
References [edit]
- ^ "Hydrops Fetalis: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine". Retrieved 2010-02-11.
- ^ Equine stud farm medicine and surgery. Retrieved 2010-02-11.
- ^ Isaacs H (January 2008). "Fetal hydrops associated with tumors". Am J Perinatol 25 (1): 43–68. doi:10.1055/s-2007-1004826. PMID 18075961.
External links [edit]
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