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of or relating to a fetus; "fetal development" (同)foetal

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/06/20 12:54:05」(JST)

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Hydrops fetalis is a condition in the fetus characterized by an accumulation of fluid, or edema, in at least two fetal compartments.^[1] By comparison, hydrops allantois or hydrops amnion is an accumulation of excessive fluid in the allantoic or amniotic space, respectively.^[2]

Signs and symptoms

Locations can include:

subcutaneous tissue/scalp
pleura (pleural effusion)
pericardium (pericardial effusion)
abdomen (ascites)

The edema is usually seen in the fetal subcutaneous tissue, sometimes leading to spontaneous abortion. It is a prenatal form of heart failure, in which the heart is unable to satisfy its demand for a high amount of blood flow.

Causes

Hydrops fetalis usually stems from fetal anemia, when the heart needs to pump a much greater volume of blood to deliver the same amount of oxygen. This anemia can have either an immune or non-immune cause. Non-immune hydrops can also be unrelated to anemia, for example if a fetal tumor or congenital cystic adenomatoid malformation increases the demand for blood flow.^{[citation needed]} The increased demand for cardiac output leads to heart failure, and corresponding edema.

Immune

Rh disease is an increasingly uncommon cause of immune-mediated hydrops fetalis. Owing to preventative methods developed in the 1970s, the incidence of Rh disease has markedly declined. Rh disease can be prevented by administration of anti-D IgG (Rho(D) Immune Globulin) injections to RhD-negative mothers during pregnancy and/or within 72 hours of the delivery. However, a small percentage of pregnant mothers are still susceptible to Rh disease even after receiving anti-D IgG (Rho(D) Immune Globulin)

Non-immune

The non-immune form of hydrops fetalis has many causes including:^[3]

Iron deficiency anemia
Paroxysmal supraventricular tachycardia resulting in heart failure
Deficiency of the enzyme beta-glucuronidase. This enzyme deficiency is the cause of the lysosomal storage disease called mucopolysaccharidosis type VII.
Congenital disorders of glycosylation
Parvovirus B19 (fifth disease) infection of the pregnant woman
Cytomegalovirus in mother
Congenital cystic adenomatoid malformation
Maternal syphilis and maternal diabetes mellitus
Alpha-thalassemia can also cause hydrops fetalis when all four of the genetic loci for α globin are deleted or affected by mutation. This is termed Hb Barts (consists of y-4 tetramers).
Uncommonly, Niemann-Pick disease Type C (NPC) and Gaucher disease type 2 can present with hydrops fetalis.
Turner Syndrome
Tumors,^[4] the most common type of fetal tumor being teratoma, particularly a sacrococcygeal teratoma.
Twin-twin transfusion syndrome in monochorionic pregnancy (hydrops affects the recipient twin)
Maternal hyperthyroidism
Fetal cardiac defects and skeletal defects
Noonan syndrome
Mirror syndrome, in which fetal and placental hydrops develops in association with maternal preeclampsia, edema and hypertension

Diagnosis

Hydrops fetalis can be diagnosed and monitored by ultrasound scans. Prenatal ultrasound scanning enables early recognition of hydrops fetalis and has been enhanced with the introduction of MCA Doppler.

Treatment

The treatment depends on the cause.

Severely anemic fetuses, including those with Rh disease and alpha thalassemia major, can be treated with blood transfusions while still in the womb. This treatment increases the chance that the fetus will survive until birth.^[3]^[5]^[6]

References

^ "Hydrops Fetalis: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine". Retrieved 2010-02-11.
^ Equine stud farm medicine and surgery. Retrieved 2010-02-11.
^ ^a ^b Norton, Mary E.; Chauhan, Suneet P.; Dashe, Jodi S. (2015-02-01). "Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #7: nonimmune hydrops fetalis". American Journal of Obstetrics and Gynecology 212 (2): 127–139. doi:10.1016/j.ajog.2014.12.018.
^ Isaacs H (January 2008). "Fetal hydrops associated with tumors". Am J Perinatol 25 (1): 43–68. doi:10.1055/s-2007-1004826. PMID 18075961.
^ Vichinsky, Elliott P. (2009-01-01). "Alpha thalassemia major—new mutations, intrauterine management, and outcomes". ASH Education Program Book 2009 (1): 35–41. doi:10.1182/asheducation-2009.1.35. ISSN 1520-4391. PMID 20008180.
^ Derderian, S. Christopher; Jeanty, Cerine; Fleck, Shannon R.; Cheng, Lily S.; Peyvandi, Shabnam; Moon-Grady, Anita J.; Farrell, Jody; Hirose, Shinjiro; Gonzalez, Juan (2015-01-01). "The many faces of hydrops". Journal of Pediatric Surgery 50 (1): 50–54. doi:10.1016/j.jpedsurg.2014.10.027. PMC 4315667. PMID 25598092.

External links

Hydrops Fetalis Community Forums

UpToDate Contents

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1. 非免疫性胎児水腫nonimmune hydrops fetalis [show details]
… spontaneous resolution of fetal hydrops related to parvovirus infection and after fetal death. Resolution is associated with a fall in sFlt1. However, prompt delivery is indicated, even in NIHF with a treatable …
2. 胎児水腫の生後ケアpostnatal care of hydrops fetalis [show details]
…prophylaxis in the 1960s, the most frequent cause of hydrops fetalis was Rh incompatibility between the mother and fetus. Nonimmune − Nonimmune hydrops fetalis (NHF) is associated with numerous disorders that …
3. Etiology, clinical manifestations, diagnosis, and evaluation of pleural effusions in the neonateetiology clinical manifestations diagnosis and evaluation of pleural effusions in the neonate [show details]
…pleural effusions are often a component of hydrops fetalis. An attempt to determine the etiology of the pleural effusion, especially in those with hydrops fetalis, should be made at the time of diagnosis …
4. 胎児および新生児における溶血性疾患の出生後診断およびマネージメントpostnatal diagnosis and management of hemolytic disease of the fetus and newborn [show details]
… diagnosis and management of alloimmune HDFN in the newborn will be reviewed here. The prenatal diagnosis and management of HDFN are discussed separately. Alloimmune HDFN primarily involves the major blood …
5. Overview of Rh(D) alloimmunization in pregnancyoverview of rh d alloimmunization in pregnancy [show details]
…antibodies. D-positive fetuses/neonates of these mothers are at risk of developing hemolytic disease of the fetus and newborn (HDFN), which can be associated with serious morbidity or mortality. Implementation …

English Journal

Early treatment of intrapericardial teratoma: a case presentation and systematic literature review.

Cavalcante CTMB, Pinto Júnior VC, Pompeu RG, Férrer JVCC, Cavalcante MB, Araujo Júnior E, Peixoto AB, Castello Branco KM.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 2019 Jul;32(13)2262-2268.
To present a case of an early treatment of cardiac intraperitoneal teratoma (IPT) in a newborn and its associated systematic literature review. We presented a case of a newborn with IPT but without hydrops and having a good perinatal outcome after cardiac surgery. Using the PubMed database, we condu
PMID 29320914

Maternal steroid therapy for fetuses with immune-mediated complete atrioventricular block: a systematic review and meta-analysis.

Ciardulli A, D'Antonio F, Magro-Malosso ER, Saccone G, Manzoli L, Radolec M, Berghella V.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 2019 Jun;32(11)1884-1892.
To explore the effect of maternal fluorinated steroid therapy on fetuses affected by immune-mediated complete atrio-ventricular block (CAVB) in utero. Pubmed, Embase, Cinahl, and ClinicalTrials.gov databases were searched. Only studies reporting the outcome of fetuses with immune CAVB diagnosed on p
PMID 29251180

Bilateral Pulmonary Artery Banding in Ebstein's Anomaly With Circular Shunting.

Hasegawa M, Iwai S, Yamauchi S, Kugo Y, Kayatani F, Takahashi K, Kawata H.
The Annals of thoracic surgery. 2019 May;107(5)e317-e319.
We present a case of critical Ebstein's anomaly with circular shunting, diagnosed in utero. The fetal cardiothoracic area ratio was elevated; tricuspid regurgitation and pulmonary regurgitation worsened with fetal hydrops. At 35 weeks 6 days of gestation, elective caesarean section delivery was perf
PMID 30359592

Japanese Journal

胎児鏡下胎盤吻合血管レーザー凝固術後も僧帽弁閉鎖不全が残存した双胎間輸血症候群受血児の1例

日本小児循環器学会雑誌 33(3), 215-220, 2017
NAID 130005712192

胎児水腫と新生児期の胆汁うっ滞性肝機能障害を認め，6歳でメバロン酸キナーゼ欠損症と診断できた女児例

日本臨床免疫学会会誌 40(2), 131-137, 2017
NAID 130005696883

パルボウイルスB19感染症に対する院内感染対策

日本環境感染学会誌 32(2), 89-93, 2017
NAID 130005655703

「胎児水腫」

Hydrops fetalis
	An ultrasound featuring a fetus with Hydrops fetalis
Classification and external resources
ICD-10	P56, P83.2
ICD-9-CM	773.3, 778.0
DiseasesDB	29715
MedlinePlus	007308
eMedicine	ped/1042
Patient UK	Hydrops fetalis
MeSH	D015160
	[edit on Wikidata]