Nonimmune Hydrops Fetalis
Barbara C. McGillivray MD1
Judith G. Hall MD2
1 Director of the Prenatal Diagnosis Program at the University of British Columbia Clinical Genetics Unit
2 Director of Clinical Genetics Services at the University of British Columbia Clinical Genetics Unit and for the province of British Columbia
Hydrops fetalis or fetal hydrops is defined as a generalized abnormal accumulation of serous fluid in the entire body including abnormal collection in tissues and body cavities. It is not a specific disease but the end result of many fetal conditions. Presentation may be prenatal with ultrasound diagnosis on at the time of delivery.
There are many causes of fetal hydrops including cardiac, pulmonary, chromosomal, hematologic, and metabolic. The mortality rate is high, with the best survival in those infants who have cardiac rhythm abnormalities.
Proper assessment of the infant with hydrops requires familiarity with the major causes and a stepwise protocol for investigation. Not only are the usual blood-grouping studies important, but also chromosomal analysis, metabolic screening, and carefully performed autopsy. The aim of the protocol that is suggested is to improve intrauterine detection and survival after birth and to ascertain the cause of the condition to aid in counseling and care in subsequent pregnancies.
