DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201661

Non-immune hydrops fetalis: a case series

Niladri Das, Sushma Malik, Prachi Gandhi, Vinaya A. Singh, Poonam Wade

Abstract


Hydrops fetalis is a clinical condition characterized by pathological fluid accumulation in soft tissues and serous cavities of the fetus like peritoneal cavity, pleural cavity, pericardial space, and body wall edema. Hydrops fetalis is broadly classified into Immune Hydrops Fetalis (IHF) and Non-Immune Hydrops Fetalis (NIHF). Incidence of immune hydrops fetalis due to Erythroblastosis fetalis secondary to Rh Iso-immunisation has drastically reduced due to widespread use of anti-D immunoglobulin. In the last few decades, the majority of cases are identified as non-immune hydrops. It is important to determine the cause of the hydrops fetalis in order to administer optimal management of the neonate at birth. Despite recent advances the mortality of non-immune hydrops is still high. Authors report here six cases of non-immune hydrops fetalis encountered at our tertiary care hospital over last three years.


Keywords


Down’s syndrome, Hydrops fetalis, Non-immune hydrops fetalis, Twin to twin transfusion syndrome

Full Text:

PDF

References


Norton, M. E., Chauhan, S. P., & Dashe, J. S. (2015). Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #7: Nonimmune hydrops fetalis. American Journal of Obstetrics and Gynecology, 212(2), 127–139. doi:10.1016/j.ajog.2014.12.018

Heinonen S, Ryynänen M, Kirkinen P. Etiology and outcome of second trimester non-immunologic fetal hydrops. Acta Obstet Gynecol Scand 2000; 79:15-8 (Level II-2).

Machin GA. Hydrops revisited: literature review of 1,414 cases published in the 1980s. Am J Med Genet 1989; 34:366-90 (Level III).

Hutchison AA, Drew JH, Yu VY, Williams ML, Fortune DW, Beischer NA. Nonimmunologic hydrops fetalis: a review of 61 cases. Obstet Gynecol 1982; 59:347-52 (Level III).

Bellini C, Hennekam RC, Fulcheri E, Rutigliani M, Morcaldi G, Boccardo F, et al. Etiology of nonimmune hydrops fetalis: a systematic review. Am J Med Genet Part A 2009; 149A:844e51.(level 1)

Lee AJ, Bethune M, Hiscock RJ. Placental thickness in the second trimester: a pilot study to determine the normal range. J Ultrasound Med 2012; 31:213-8 (Level II-3).

Hoddick WK, Mahony BS, Callen PW, Filly RA. Placental thickness. J Ultrasound Med 1985; 4:479-82 (Level II-3).

Trainor B, Tubman R (2006) The Emerging pattern of Hydrops Fetalis – Incidence, etiology, and management. Ulster Med J 75(3): 185-186.

Moreno, C. A., Kanazawa, T., Barini, R., Nomura, M. L., Andrade, K. C., Gomes, C. P. … Cavalcanti, D. P. (2013). Non-immune hydrops fetalis: A prospective study of 53 cases. American Journal of Medical Genetics Part A, 161(12), 3078–3086. doi:10.1002/ajmg.a.36171

Laterre, M., Bernard, P., Vikkula, M., & Sznajer, Y. (2018). Improved diagnosis in nonimmune hydrops fetalis using a standardized algorithm. Prenatal Diagnosis, 38(5), 337–343. doi:10.1002/pd.5243

Liao C, Wei J, Li Q, Li J, Li L, Li D. Nonimmune hydrops fetalis diagnosed during the second half of pregnancy in Southern China. Fetal Diagn Ther 2007; 22:302-5 (Level II-2).

Suwanrath-Kengpol C, Kor-anantakul O, Suntharasaj T, Leetanaporn R. Etiology and outcome of non-immune hydrops fetalis in southern Thailand. Gynecol Obstet Invest 2005; 59:134-7 (Level II-2).

Ota S, Sahara J, Mabuchi A, et al. Perinatal and one-year outcomes of non-immune hydrops fetalis by etiology and age at diagnosis. J Obstet Gynaecol Res. 2015; 42(4):385–91.

Fesslova V, Villa L, Nava S, Boschetto C, Redaelli C, Mannarino S. Spectrum and outcome of atrioventricular septal defect in fetal life. Cardiol Young 2002; 12:18-26 (Level II-2).

Bellini C, Hennekam RC. Non-immune hydrops fetalis: a short review of etiology and pathophysiology. Am J Med Genet 2012; 158A:597-605 (Level III).

Abrams ME, Meredith KS, Kinnard P, Clark RH. Hydrops fetalis: a retrospective review of cases reported to a large national database and identification of risk factors associated with death. Pediatrics 2007;120: 84-9 (Level II-2)

Hofstaetter C, Hansmann M, Eik-Nes SH, Huhta JC, Luther SL. A cardiovascular profile score in the surveillance of fetal hydrops. J Matern Fetal Neonatal Med 2006; 19:407-13 (Level II-2).

Randenberg AL. Nonimmune hydrops fetalis part II: does etiology influence mortality? Neonatal Netw 2010;29:367-80 (Leve l III)

Van Den Wijngaard JP, Ross MG, Van Gemert MJ. Twin-twin transfusion syndrome modeling. Ann N Y Acad Sci 2007; 1101:215-34 (Level III).

Society for Maternal-Fetal Medicine, Simpson LL. Twin-twin transfusion syndrome. Am J Obstet Gynecol 2013; 208:3-18 (Level III).