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Dec 29, 2023

Hydrops Fetalis: Symptoms, Causes, and Treatment

Hydrops fetalis, also known as fetal hydrops, is a severe problem in unborn and

Hydrops fetalis, also known as fetal hydrops, is a severe problem in unborn and newborn babies. It is the collection of fluid in two or more chambers of the baby's body. Without treatment, the excess fluid can threaten the baby's life. The fluid can harm the baby's heart and other vital organs.

Hydrops fetalis is not a disease on its own. It is a symptom of many diverse health problems affecting the fetus or newborn. These issues can impact the baby's heart, lungs, genes, and immune system.

Diagnosis of this problem usually takes place while the baby is a fetus. The treatment and prognosis of a baby with this condition can vary significantly based on the health issue causing the problem.

This article describes hydrops fetalis symptoms, causes, diagnosis, treatment, and outlook.

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There are two types of hydrops fetalis:

Symptoms of hydrops fetalis may occur differently in every baby.

The following symptoms of hydrops fetalis can occur during pregnancy:

The following hydrops fetalis symptoms can occur immediately at birth:

Causes of hydrops fetalis vary greatly. The type of hydrops fetalis that a baby has is based on its causes.

Nonimmune Hydrops Fetalis

There are many possible causes of nonimmune hydrops, including the following:

Immune Hydrops Fetalis

Immune hydrops fetalis is triggered when the mother's immune system attacks the unborn baby's red blood cells. This often occurs because of the Rhesus (Rh) factor protein. If the mother is Rh negative and the baby is Rh positive, the mother's immune system identifies the unborn baby's red blood cells as "foreign invaders." It fights them with antibodies, destroying the baby's red blood cells. Anemia can occur.

In most red blood cell incompatibility cases, the baby experiences only mild to moderate health problems. However, in about 25% of these cases, the baby's organs can't overcome anemia, and the heart can start to fail. This causes large amounts of fluid to collect in the baby's tissue and organs.

A diagnosis of hydrops fetalis usually takes place before the baby is born. It may involve the following studies:

Treatment for hydrops fetalis varies based on the cause of the condition, the extent, and the severity of the condition as well as the baby's gestational age. In many cases, treatment during pregnancy isn't possible.

When possible, treatments can include the following types of interventions:

Whether treatment is possible or not, the goal is to help the baby avoid an early delivery, which could threaten the baby's life. However, in some cases, the mother can develop "mirror syndrome," in which the mother's symptoms "mirror" the fluid buildup in the baby. This condition requires the immediate delivery of the baby.

The incidence of immune hydrops fetalis has significantly dropped since the 1960s when a medicine called RhoGAM was introduced. Women who have a pregnancy at risk of Rh incompatibility are routinely given this drug. RhoGAM prevents the mother's immune system from making antibodies that destroy her baby's red blood cells.

The prognosis for hydrops fetalis is affected by Multiple factors including underlying causes and the success of treatment affect the prognosis of hydros fetalis. Generally, the prognosis for babies with this condition is poor, with about a 50% survival rate.

A diagnosis of hydrops fetalis during pregnancy usually requires close monitoring of the pregnancy whether treatment is performed or not. You can expect close monitoring and testing to evaluate the baby's health from the diagnosis.

Management of a pregnancy involving a baby with hydrops fetalis is usually handled by a multidisciplinary care team that can include a maternal-fetal specialist, pediatric cardiologist, neonatologist, geneticist, nurse specialist care coordinator, and other specialists who can cater to the physical and emotional challenges of having a baby with this condition.

Hydrops fetalis involves the collection of fluid in an unborn or newborn baby. With this problem, the fluid exists in at least two chambers of the baby's body. The problem can cause excess fluid around the baby's heart and other organs. This, in turn, can cause a severe issue that can threaten a baby's life.

Hydrops fetalis can occur as a symptom of many types of birth defects. It can also evolve due to a blood incompatibility between the mother and the baby owing to differences in their blood's Rh factors.

Though routine ultrasound finds most cases, symptoms such as decreased fetal movement may trigger the need for further tests to assess the baby's health. In some cases, the mother may also have health problems resulting from the condition, causing the need for an early delivery.

Women whose babies have this problem should expect close monitoring and testing until the baby is born. The goal is to optimize delivery timing based on symptoms in utero. The advised treatment and outcomes can vary based on the health problem causing the issue.

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Orphanet. Immune hydrops fetalis.

Mathias CR, Rizvi C. The diagnostic conundrum of maternal mirror syndrome progressing to preeclampsia — a case report. Case Rep Womens Health. 2019;23:e00122. doi:10.1016/j.crwh.2019.e00122

By Anna GiorgiAnna Zernone Giorgi is a writer who specializes in health and lifestyle topics. Her experience includes over 25 years of writing on health and wellness-related subjects for consumers and medical professionals, in addition to holding positions in healthcare communications.