Nonimmunologic Hydrops Fetalis: A Review of 19 Cases

Abstract

Nineteen cases of nonimmunologic hydrops fetalis occurring during a nine-year period were reviewed. The pregnancies were complicated by hydramnios (78%) and preterm delivery (84%). Hydramnios appears to be the most useful indicator of the pregnancy at risk; its occurrence should prompt ultrasonographic investigation for evidence of hydrops. Modalities available for antenatal diagnosis of underlying fetal abnormalities include amniocentesis, serologic tests, fetal cardiac monitoring, radiography, hemoglobin electrophoresis and glucose tolerance testing. A specific cause for the hydrops may not be detectable (42% of our cases were idiopathic). Management of affected pregnancies is influenced by the frequent occurrence of fetal asphyxia and premature delivery. Outcome is poor: only 32% of the babies survived beyond the neonatal period. Symptomatic treatment for the neonate includes fluid restriction, maintenance of blood sugar, support of ventilation and attention to the complications of asphyxia.

Intrauterine Brain Damage in Nonimmune Hydrops Fetalis

“…Nonimmune hydrops fetalis has been de scribed in a great variety of pathological con ditions [1][2][3][4][5][6][7][8][9] but brain aspect has been poorly explored [10][11][12], Nowadays, the diagnosis of hydrops is usually made on fetal ultrasono grams, and investigations can be undertaken to identify the cause or the associated patho logical conditions. Therefore, today, many pregnancies are interrupted.…”

Intrauterine Anoxic Brain Damage in Nonimmune Hydrops fetalis

“…Our inability to determine a definite cause of the hydrops is not surprising as most ma jor reviewers list 30-65% of cases as idio pathic [5,18]. On the other hand, Moerman et al [13] were able to ascribe the hydrops to specific pathologic findings in 8 out of 10 cases.…”

Recurrent Non-immune Fetal Hydrops: A Case Report

“…The number of idiopathic NIH varies from 9% to 42%. 8,9 A recessive inheritance may be recognised by occurrence in siblings of a family, which may represent a distinct, frequently unrecognised condition. 10,11 Other investigations that may have yielded significant results but were not done are parental G6PD and pyruvate kinase carrier status, maternal alpha-fetoprotein, fetal liver enzymes and serum albumin and white cell enzymes (Gaucher's disease, mucopolysaccharidosis).…”