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Hydrops fetalis

Hydrops fetalis is a serious condition. It occurs when abnormal amounts of fluid build up in two or more body areas of a fetus or newborn. It is a symptom of underlying problems.

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Hydrops fetalis

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Causes

There are two types of hydrops fetalis, immune and nonimmune. The type depends on the cause of the abnormal fluid.

The number of babies who develop immune hydrops fetalis has dropped due to a medicine called RhoGAM. This drug is given as an injection to pregnant mothers who are at risk for Rh incompatibility. The drug prevents them from making antibodies against their babies' red blood cells. (There are other, much rarer, blood group incompatibilities that can also cause immune hydrops fetalis, but RhoGAM does not help with these.)

Symptoms

Symptoms depend on the severity of the condition. Mild forms may cause:

More severe forms may cause:

Exams and Tests

An ultrasound done during pregnancy may show:

An amniocentesis and frequent ultrasounds will be done to determine the severity of the condition.

Treatment

Treatment depends on the cause. During pregnancy, treatment may include:

Treatment for a newborn may include:

Outlook (Prognosis)

Hydrops fetalis often results in death of the infant shortly before or after delivery. The risk is highest for babies who are born very early or who are ill at birth. Babies who have a structural defect, and those with no identified cause for the hydrops are also at higher risk.

Possible Complications

Brain damage called kernicterus may occur in the case of Rh incompatibility. Developmental delays have been seen in babies who received intrauterine transfusions.

Prevention

Rh incompatibility can be prevented if the mother is given RhoGAM during and after pregnancy.

References

Langlois S, Wilson RD. Fetal hydrops. In: Pandya PP, Oepkes D, Sebire NJ, Wapner RJ, eds. Fetal Medicine: Basic Science and Clinical Practice. 3rd ed. Philadelphia, PA: Elsevier; 2020:chap 36.

Simmons PM, Magann EF. Immune and nonimmune hydrops fetalis. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 23.

Suhrie KR, Tabbah SM. High-risk pregnancies. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 114.

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Review Date: 5/24/2021  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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