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Hydrops fetalis is a condition where abnormal amounts of fluid build up in fetuses or newborns, causing potential danger. It can be caused by anemia, heart failure, or lymphatic blockage, and is diagnosed through ultrasound. Treatment depends on the cause and timing of diagnosis.
Hydrops fetalis, or hydrops fetalis, is a condition in fetuses or newborns in which abnormal and potentially dangerous amounts of fluid build up in the heart, lungs or abdomen, or under the skin. For hydrops fetalis to be diagnosed as such, at least two of these spaces must be affected by accumulated fluid. This condition can be caused by anemia, congestive heart failure, and blockage of the lymphatic system. Symptoms of hydrops fetalis include skin bruising, liver swelling, severe jaundice, difficulty breathing, severe anemia, and heart failure.
The fetus is particularly vulnerable to changes in fluid production and circulation, and therefore to fluid accumulation. This vulnerability is present because fetal capillaries are more permeable, meaning fluid can get in and out more easily. When diseases such as anemia or heart failure cause the heart to become less efficient, the heart has to work harder to deliver oxygen. The result is increased pressure on the veins, increased permeability of the capillaries and an increased tendency for fluid to form in certain locations.
The most common cause of hydrops fetalis is anemia, characterized by reduced oxygen levels in the blood. This condition reduces the efficiency of the heart and makes it work harder. Fetal anemia can be caused by genetic defects and heart or lung problems. Another cause of fetal anemia is Rhesus incompatibility between the pregnant woman and the fetus she is carrying.
Rhesus incompatibility is caused by blood group differences between the pregnant woman and the fetus. There is a risk of Rhesus incompatibility which occurs when a pregnant woman is Rhesus factor negative and the fetus is Rhesus factor positive. In this situation, the woman’s immune system can attack the baby’s red blood cells, causing severe anemia. Rhesus incompatibility can be avoided with immunotherapy drugs that prevent the woman’s immune system from attacking red blood cells.
Fetal hydrops is usually diagnosed during an ultrasound, a test that is done several times during a typical pregnancy to screen for this and other problems. If a fetus has hydrops, an ultrasound will show excess amniotic fluid in the uterus and a larger-than-normal placenta. The ultrasound will also pinpoint areas where excess fluid has built up in the fetus.
Treatment for hydrops fetalis depends on the cause of the condition and whether hydrops was present before or at birth. If the condition is diagnosed before birth and the fetus is old enough to survive outside the womb, early labor can be induced. If this is not possible and the hydrops is caused by anemia, the fetus may be given an intrauterine blood transfusion.
After birth, the newborn receives additional treatment. When congestive heart failure is the cause, for example, treatment includes medications to help remove excess fluid from the body to relieve the strain on the heart and kidneys. If the condition is caused by anemia, the child is given one or more blood transfusions to replace the lost red blood cells.
