Foetal hydrops: new challenges

Abstract

Background Foetal Hydrops (FH) is an abnormal accumulation of fluid inside two or more serous cavities and may be linked with polyhydramnios and/or placental oedema. It has been correlated with several causes such foetal anaemia, chromosomal anomalies, congenital abnormalities, infections, twin-to-twin transfusion syndrome and maternal causes such as diabetes. Regardless the advances in diagnosis and therapy, the overall perinatal mortality rate remains high. Thereby, the main goal is to evaluate the autopsy findings including between 2010 and 2019. Methods 105 cases including perinatal and new-born autopsies with different gestation stages were studied, in order to understand the macroscopic and microscopic events that can elucidate FH. Results Macroscopically, a large number of foetuses demonstrated oedema effusions and intrauterine growth restriction. Regarding placenta, the most common macroscopic finding is oedema, such as described in the literature. Nodules and hemorrhagic areas are the new findings observed. Oedema remains the most relevant microscopic finding, whereas unspecified villi alterations and trophoblast pseudoinclusions were the new findings. Conclusions The results allowed the identification of new characteristics that can contribute to the knowledge of this foetal condition that remains a challenge. Future studies need to focus on identifying strategies for diagnosis and treatment is critical for foetal hydrops.