Non-immunologic hydrops fetalis and coronavirus disease (COVID-19) – A case report

Abstract

Non-immune hydrops fetalis is a severe fetal condition defined as the excessive accumulation of fetal fluid within the fetal extravascular compartments and body cavities. The prevalence of non-immune hydrops fetalis is unknown. Currently, about 90% of cases of hydrops fetalis are non-immune hydrops fetalis. Non-immune hydrops fetalis causes are multi-factorial. The pathophysiological mechanism of non-immunologic hydrops fetalis is related to abnormal fluid transportation between plasma and tissues. This is due to the increase in hydrostatic capillary pressure and capillary permeability and a reduction of the plasma osmotic pressure or lymphatic flow. A variety of viral infection agents have been associated with non-immune hydrops fetalis like parvovirus B19, herpes simplex virus, cytomegalovirus, Toxoplasma gondii, Treponema pallidum, but even other viruses that attack the maternal and fetus during pregnancy cannot be excluded as possible causes of non-immune hydrops fetalis. We present one case of non-immune hydrops fetalis who was diagnosed intra-uterine, three weeks after recovery from Coronavirus disease (COVID-19). After much investigation, we could not find any known factor that may be the cause of non-immunologic hydrops fetalis. Therefore, we predisposed a possible causal connection between nonimmunologic hydrops fetalis and Coronavirus disease (COVID-19).

A case of COVID-19 in pregnancy complicated by fetal pleural effusion

“…Secondary pleural effusion, like ascites, pericardial effusions or subcutaneous tissue edema in the fetus, is usually caused by generalized fluid retention in non-immune hydrops [13]. Bellini et al [14] in their systematic literature review made a classification based on the cause: cardiovascular causes (20.1%), lymphatic dysplasia (15.0%), hematologic (9.3%), chromosomal (9.0%), infections (7.0%), syndromic (5.5%), TTTF--placental (4.1%), miscellaneous (3.6%), thoracic (2.3%), inborn errors of metabolism (1.3%), gastrointestinal (1.3%), urinary tract malformations (0.9%), and extra thoracic tumors (0.7%).…”

“…In our case, all of the potential threats were excluded. From the available reports, we know of several pregnancies complicated by non-immune hydrops with symptoms such as pericardial effusion [15], peritoneal effusion [8,9,13] and subcutaneous tissue edema [2,9,13].…”

Arthrogryposis Multiplex Congenita (AMC): Functional Improvement of a Seven-Year-Old Girl after 3 Years of Physical Medical Rehabilitation Intervention

“…Developmental stimulation is also an essential program that should not be neglected. The articular limitation of the patient with arthrogryposis can influence their cognitive development and motor function 2,8,14 .…”