Hydrops fetalis

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]

Hydrops fetalis
An ultrasound showing a fetus with Hydrops fetalis
SpecialtyObstetrics and gynaecology, hematology, immunology 

Signs and symptoms

Locations can include:

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 demand (in most cases abnormally high) for blood flow.


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. The increased demand for cardiac output leads to heart failure, and corresponding edema.


  • Rh disease is an increasingly uncommon cause of immune-mediated hydrops fetalis. Due 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)


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


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.


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]

See also


  1. "Hydrops Fetalis: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine". Retrieved 2010-02-11.
  2. Knottenbelt, Derek C. (2003). Equine stud farm medicine and surgery. ISBN 9780702021305. Retrieved 2010-02-11.
  3. 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. PMID 25557883.
  4. Isaacs H (January 2008). "Fetal hydrops associated with tumors". Am J Perinatol. 25 (1): 43–68. doi:10.1055/s-2007-1004826. PMID 18075961.
  5. 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.
  6. 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 resources
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