Hydrops Fetalis

Also known as: Fetal hydrops, hydrops, erythroblastosis fetalis.

What is hydrops fetalis?

Hydrops fetalis is an abnormal collection of fluid in at least two different organ spaces (like the skin, abdomen, around the heart and/or lungs) causing massive swelling. It is a severe, life-threatening problem in fetuses and/or newborns.

There are two major types:

  • immune (also called erythroblastosis fetalis)
  • non-immune hydrops

What causes hydrops fetalis?

The immune type of hydrops fetalis occurs when the mother’s immune system attacks and destroys the fetus/baby’s red blood cells. This results from an incompatibility of blood group types between the mother and baby.

Non-immune hydrops (more common) results from the baby's inability to manage fluid. Diseases associated with this include:

  • Severe anemia
  • Infections that occur before birth (congenital)
  • Abnormalities of the baby's chromosomes
  • Liver and heart defects, etc.

In some babies the cause may not be found.

What are the symptoms of hydrops fetalis?

These can vary but frequently include:

  • Before birth:
    • Large amounts of amniotic fluid (polyhydramnios)
    • A thick placenta
    • Enlarged organs (liver, spleen, heart) and
    • Fluid in the abdomen, and/or around the heart/lungs
  • After birth:
    • Pale color (anemia)
    • Yellow color (jaundice)
    • Large liver and spleen
    • Difficulty breathing
    • Fluid in the abdomen with swelling of limbs

What are hydrops fetalis care options?

Treatments depend on the cause and severity. Early delivery, blood transfusions (before and/or after birth), supportive treatments with oxygen and/or breathing machines, removal of fluid if it interferes with lung/heart function and managing any underlying causative condition.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: September 30, 2020 02:39 PM

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