Chilton Medical Center - ATLANTIC HEALTH SYSTEM
Decrease (-) Restore Default Increase (+)  font size
PrintEmail
Search Health Information   

Hydrops fetalis
Hydrops fetalis


Hydrops fetalis

Definition:

Hydrops fetalis is a serious condition in which abnormal amounts of fluid build up in two or more body areas of a fetus or newborn.

See also: Erythroblastosis fetalis



Causes, incidence, and risk factors:

There are two types of hydrops fetalis: Immune and nonimmune. The exact cause depends on which form a baby has.

  • Immune hydrops fetalis is a complication of a severe form of Rh incompatibility . Rh compatibility causes massive red blood cell destruction, which leads to several problems, including total body swelling. Severe swelling can interfere with how the body organs work.
  • Nonimmune hydrops fetalis occurs when a disease or medical condition disrupts the body's ability to manage fluid. There are three main causes for this type: heart or lung problems, severe anemia (thalassemia), and genetic defects, including Turner syndrome .

The number of babies who develop immune hydrops fetalis has dramatically decreased since the introduction of the medicine RhoGAM, which is used to treat pregnant mothers at risk for Rh incompatibility.



Symptoms:

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

  • Liver swelling
  • Change in skin color (pallor)

More severe forms may cause:

  • Breathing problems
  • Bruising or purplish bruise-like spots on the skin
  • Heart failure
  • Severe anemia
  • Severe jaundice
  • Total body swelling


Signs and tests:

An ultrasound done during pregnancy may show:

  • High amounts of amniotic fluid
  • Abnormally large placenta
  • Fluid that leads to swelling in the unborn baby's belly area and organs, including the liver, spleen, heart, or lung area

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:

  • Medicine to cause early labor and delivery of the baby
  • Early cesarean delivery if condition gets worse
  • Giving blood to the baby while still in the womb (intrauterine fetal blood transfusion)

Treatment for a newborn may include:

  • Direct transfusion of packed red blood cells (compatible with the infant's blood type) and an exchange transfusion to rid the baby's body of the substances that are destroying the red blood cells
  • Using a needle to remove extra fluid from around the lungs and belly area
  • Medicines to control heart failure and help the kidneys remove extra fluids
  • Methods to help the baby breathe, such as a breathing machine


Expectations (prognosis):

Hydrops fetalis often results in death of the infant shortly before or after delivery. The risk is highest among the most premature babies and those who are severely ill at birth.



Complications:

Brain damage called kernicterus may occur.



Prevention:

Rh incompatibility, which can lead to this condition, can be prevented if the mother takes a medicine called RhoGAM at certain times during and after pregnancy.



References:

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 Jul;120(1):84-9.

Kumar V, Abbas AK, Fausto N. Robbins and Cotran Pathologic Basis of Disease. 7th ed. St. Louis, Mo: WB Saunders; 2005.




Review Date: 5/9/2011
Reviewed By: Kimberly G Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com


Morristown Medical Center
100 Madison Avenue
Morristown, NJ 07960
973-971-5000

Overlook Medical Center
99 Beauvoir Avenue
Summit, NJ 07901
908-522-2000

Newton Medical Center
175 High Street
Newton, NJ 07860
973-383-2121

Chilton Medical Center
97 West Parkway
Pompton Plains, NJ 07444
973-831-5000

Goryeb Children's Hospital
100 Madison Avenue
Morristown, NJ 07960
973-971-5000

© 2014 Chilton Medical Center, 97 West Parkway, Pompton Plains, New Jersey 1-973-831-5000