WordNet

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）』「2013/01/15 16:43:06」(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 are an accumulation of excessive fluid in the allantoic or amniotic space respectively.^[2]

Presentation

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.

Classification and 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 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 causes

Rh disease is a cause for immune mediated hydrops fetalis; however, owing to preventative methods developed in the 1970s 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 having been administered anti-D IgG (Rho(D) Immune Globulin)

Non-Immune causes

The non-immune form of hydrops fetalis has many causes including:

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.
Maternal syphilis.
α 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,^[3] 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

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 can be treated with blood transfusions while still in the womb.

References

^ "Hydrops Fetalis: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine". http://emedicine.medscape.com/article/974571-overview. Retrieved 2010-02-11.
^ Equine stud farm medicine and surgery. http://books.google.co.uk/books?id=uVaQTJwuyUQC&pg=PA298&dq=hydrops+amnion&hl=en&ei=9XjpTPXtKca2hAexy6kQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CC8Q6AEwAQ#v=onepage&q=hydrops%20amnion&f=false. Retrieved 2010-02-11.
^ Isaacs H (January 2008). "Fetal hydrops associated with tumors". Am J Perinatol 25 (1): 43–68. doi:10.1055/s-2007-1004826. PMID 18075961. http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-1004826.

External links

Hydrops Fetalis Community Forums

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 非免疫性胎児水腫 nonimmune hydrops fetalis
2. 胎児水腫の生後ケア postnatal care of hydrops fetalis
3. 妊娠中のパルボウイルスB19感染 parvovirus b19 infection during pregnancy
4. 死産の発生率、病因、および予防 incidence etiology and prevention of stillbirth
5. 胎児母体間大量出血の診断および管理 diagnosis and management of massive fetomaternal hemorrhage

English Journal

Novel frameshift mutation (Pro171fsX21) in neonatal type 2 Gaucher's disease.

Park HW, Lee Y, Kim GH, Lee BS, Kim KS, Yoo HW, Kim EA.SourceDepartment of Pediatrics, Konkuk University Hospital, Konkuk University School of Medicine, Korea.
Gene.Gene.2012 Oct 10;507(2):170-3. Epub 2012 Jul 5.
Gaucher's disease is caused by a deficiency of glucocerebrosidase (GBA) and results in the accumulation of glucocerebroside within macrophages. We report on a 33(+2) gestational week premature infant whose family history was significant for a previously undiagnosed premature sibling with similar cli
PMID 22772462

[Prenatal symptoms and diagnosis of inherited metabolic diseases.]

Brassier A, Ottolenghi C, Boddaert N, Sonigo P, Attié-Bitach T, Millischer-Bellaiche AE, Baujat G, Cormier-Daire V, Valayannopoulos V, Seta N, Piraud M, Chadefaux-Vekemans B, Vianey-Saban C, Froissart R, de Lonlay P.SourceCentre de référence des maladies héréditaires du métabolisme de Necker, hôpital Necker-Enfants-Malades, université Paris Descartes, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie.Arch Pediatr.2012 Aug 8. [Epub ahead of print]
Inherited metabolic diseases are mostly due to enzyme deficiency in one of numerous metabolic pathways, leading to absence of a compound downstream from and the accumulation of a compound upstream from the deficient metabolite(s). Diseases of intoxication by proteins (aminoacidopathies, organic acid
PMID 22884749

Japanese Journal

巨大硬膜動静脈瘻に対しコイル塞栓術を施行した早産児例

佐藤裕子,饗場智,閑野将行,渡辺哲,内田俊彦,渡辺眞史
日本未熟児新生児学会雑誌 = Journal of Japan Society for Premature and Newborn Medicine 23(2), 59-64, 2011-06-15
NAID 10029414220

Formation of a membrane from repeated thoracostomy and thoracoamniotic shunting

KAWAMURA Masanari,ISHIDA Wako,MIURA Shinobu,YONEYAMA Noriko,SATOH Yoko,OGUMA Rena,YOSHIDA Makoto,HIRANO Hideto,TAKAHASHI Tsutomu
Pediatrics international : official journal of the Japan Pediatric Society 53(2), 244-247, 2011-04-01
NAID 10029557972

Related Pictures

★リンクテーブル★

リンク元	「胎児水腫」「新生児溶血性疾患」
関連記事	「fetal」「hydrops」「hydro」

「胎児水腫」

Hydrops fetalis
	Classification and external resources
	; An ultrasound featuring a baby with Hydrops fetalis
ICD-10	P56, P83.2
ICD-9	773.3, 778.0
DiseasesDB	29715
MedlinePlus	007308
eMedicine	ped/1042
MeSH	D015160

　　[★]

英: fetal hydrops, hydrops fetal
ラ: hydrops fetalis
関: 先天性胎児全身水腫

概念

胎児水腫とは以下の所見を2つ以上そなえるものである；(1)腹水、(2)胸水、(3)心嚢水、(4)浮腫(skin edema)、(5)羊水過多　(参考1)

分類

免疫性胎児水腫　：血液型不適合妊娠による胎児貧血
非免疫性胎児水腫：心奇形、胎児不整脈、染色体異常(ターナー症候群?、18トリソミー?、21トリソミー?)、感染症(パルボウイルスB19、サイトメガロウイルス)

病態生理

非免疫性胎児水腫

参考1

明らかになっていないが、以下の異常が1つ以上組み合わさって生じている。

1. リンパ管の閉塞 (ex. 先天奇形、悪性腫瘍)
2. 脈管の透過性亢進 (ex. 感染)
3. 心筋の不全(myocardial failure) or 静脈還流路の閉塞
4. 浸透圧の減少 (肝疾患、腎疾患、非免疫的機序を介さない貧血)

疫学

非免疫性胎児水腫がほとんど。免疫性胎児水腫は予防方法が発達してきたため、胎児水腫の90%を非免疫性胎児水腫が占め、有病率は1500-3800出産に1例となっている(参考1)。

診断

経腹壁超音波検査

予後

免疫性胎児水腫に比べて非免疫性胎児水腫の予後はよくない。(QB.P-257)
非免疫性胎児水腫は周産期死亡の50-98%と関連している。予後に影響を与える要素は発症時の胎齢と胸水の存在で、胎齢20週以下での胸水を伴う胎児水腫の発症は予後が悪い。胸水の存在により肺の低形成をきたすためである。(参考1)

参考

1. [charged] Nonimmune hydrops fetalis - uptodate [1]

国試

103I002

「新生児溶血性疾患」

　　[★]

英: hemolytic disease of the newborn HDN
ラ: morbus haemolyticus neonatorum MHN
同: 胎児赤芽球症 fetal erythroblastosis erythroblastosis fetalis、新生児重症黄疸 icterus gravis neonatorum、胎児溶血性疾患
関: 新生児溶血性貧血、胎児水腫 hydrops fetalis

[show details]

胎児溶血性疾患 : 63 件
新生児溶血性疾患 : 約 8,050 件

参考

1.

https://www.jstage.jst.go.jp/article/jscc1971b/8/3-4/8_277/_pdf

「fetal」

　　[★]

adj.

胎生期の、胎性の、(人間)胎児の、胎児性の、(動物)胎仔の、胎仔型の

関: embryo、embryonal、embryonic、embryonic day、embryonic form、embryonic stage、fetal stage、feto、fetus、foetal、foetus

「hydrops」

　　[★]

水症

関: dropsy、edema、hydropic、hydropical

「hydro」

　　[★] ヒドロ、ハイドロ

[urlHydrops_Fetalis:_eMedicine_Pediatrics:_Cardiac_Disease_and_Critical_Care_Medicine-1] "Hydrops Fetalis: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine". http://emedicine.medscape.com/article/974571-overview. Retrieved 2010-02-11.

[urlEquine_stud_farm_medicine_and_surgery-2] Equine stud farm medicine and surgery. http://books.google.co.uk/books?id=uVaQTJwuyUQC&pg=PA298&dq=hydrops+amnion&hl=en&ei=9XjpTPXtKca2hAexy6kQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CC8Q6AEwAQ#v=onepage&q=hydrops%20amnion&f=false. Retrieved 2010-02-11.

[pmid18075961-3] Isaacs H (January 2008). "Fetal hydrops associated with tumors". Am J Perinatol 25 (1): 43–68. doi:10.1055/s-2007-1004826. PMID 18075961. http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-1004826.

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案内

案内

hydrops fetalis