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In the name of God

In the name of God. Hydrops Fetalis. Hydrops = Generalized subcutaneous edema in the fetus or neonate. Definition : Excess serous fluid in at least one space (ascites, pleural effusion, or pericardial effusion) + skin edema (> 5 mm thick) Excess fluid in two spaces without edema.

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In the name of God

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  1. In the name of God

  2. Hydrops Fetalis

  3. Hydrops = Generalized subcutaneous edema in the fetus or neonate

  4. Definition : • Excess serous fluid in at least one space (ascites, pleural effusion, or pericardial effusion) + skin edema (> 5 mm thick) • Excess fluid in two spaces without edema

  5. Immune Hydrops Fetalis (10%) Hydrops Fetalis Non Immune Hydrops Fetalis (90%)

  6. Pathogenesis • Anemia • Cardiac failure • Fetal Hypoxemia

  7. Pathogenesis (cont). • Extra vascular protein leakage → increased capillary permeability → hypoalbuminemia → Accumulation of fluid in body cavities • Placental perfusion abnormalities

  8. Etiology • Hematologic: Due to anemia (10% of cases) : • Isoimmune hemolytic disease (RH incompatibility). • Hemozygous alphathalassemia • Hemozygous G6PD d, • Feto maternal hemorrhage - twin - to twin transfusion • Bone marrow failure - bone marrow replacement - leukemia

  9. In RH incompatibility : • Fetus is RH + / mother is RH – • Maternal exposure to foreign antigens → IgG antibodies fetal antigens → destruction of fetal RBCs → Hemolysis hydrops fetal anemia → reticulocytosis (Hb<7 g/dL)→ erythroblastosis. Against In severe form In moderate form In severe form

  10. Cardiovascular: Due to heart failure (20% cases) • Rhythm disturbances • Major cardiac disease

  11. Renal (5% of cases) Nephrosis, RVT, urinary obstruction

  12. Infection (8% of cases) TORCH-Syphilis-Congenital Hepatitis, Parvovirus….

  13. Pulmonary (5% of cases) Chylothorax, diaphragmatic hernia , intrathoracic mass

  14. Placental or cord (rare)

  15. Maternal conditions (5% of cases) : Toxemia, diabetes, thyrotoxicosis

  16. Gastrointestinal (5% of cases) : Meconium peritonitis …..

  17. Chromosomal (5% of cases) : Turner syndrome, trisomy 13,18,21

  18. Miscellaneous (10% of cases) : Cystic hygroma, wilms’ tumor – teratoma - Neuroblastom

  19. Unknown (20% of cases) :

  20. Signs of hydrops : • Pericardial & pleural effusions • Ascites • Skin edema • Hepatosplenomegaly • Polyhydramnios • Placental thickening

  21. Diagnosis : • Pregnant woman with : • Polyhydramnios, severe anemia, toxemia, isoimmune disease → ultrasonic examination → Fluid accumulation in the fetus or placenta of circulating maternal antibody → NIHF In the absence

  22. Post natal Evaluation

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