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Nonimmune Hydrops Fetalis
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Chelsea DeBolt, Katherine Connolly, Mary E. Norton, Joanne Stone
Hydrops fetalis is the end stage of many different disorders, characterized by the pathologic accumulation of fluid in body cavities or tissues. The diagnosis of NIH (non-immune hydrops) is established if at least two of the following conditions are present: Hydrothorax, ascites, pericardial effusion, and skin edema (>5 mm measured at the level of skull or chest wall) (Figure 56.1). These diagnostic findings can be associated with polyhydramnios (in 40–75% of cases) and placentomegaly (placental thickness ≥4 cm in the second trimester or ≥6 cm in the third trimester) [1]. Immune hydrops is associated with alloimmunization to an RBC antigen (e.g., Rh disease) (see Chapter 55), while NIH includes all other etiologies.
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Hydrops fetalis is identified on antenatal scans of a male fetus in the second trimester of pregnancy. Following close observation of the mother into the third trimester, the baby boy is delivered early by emergency caesarean section. The baby suffers with respiratory distress and is transferred immediately to the neonatal intensive care unit where a chest radiograph is obtained. The lungs appear clear; however there are bilateral pleural effusions. Drainage of the pleural fluid reveals chylous effusions.
Intracranial Cysts
Published in Amar Bhide, Asma Khalil, Aris T Papageorghiou, Susana Pereira, Shanthi Sairam, Basky Thilaganathan, Problem-Based Obstetric Ultrasound, 2019
Amar Bhide, Asma Khalil, Aris T Papageorghiou, Susana Pereira, Shanthi Sairam, Basky Thilaganathan
The aneurysm of vein of Galen is a rare malformation of the posterior cranial fossa. Vein of Galen is not a cyst, but rather a cranial venous sinus, which undergoes massive dilatation. Color flow mapping will show presence of moving blood. It can lead to a cardiac strain as evidenced by cardiac enlargement and increased pulsatility of the ductus venosus blood flow. In severe cases, hydrops fetalis can result.
Transient abnormal myelopoiesis in Down syndrome: Experience of long term follow up from a single tertiary center in Thailand
Published in Pediatric Hematology and Oncology, 2023
Thirachit Chotsampancharoen, Shevachut Chavananon, Pornpun Sripornsawan, Natsaruth Songthawee, Edward B. McNeil
Although the majority of patients with DS and TAM in earlier studies had mild clinical manifestations and spontaneous resolution, many other studies have reported life threatening symptoms with TAM such as hydrops fetalis, congestive heart failure, liver fibrosis and/or renal dysfunction, with fatality rates of approximately 10%.3–5,7,19,21 Zipursky et al. reported on four patients with severe TAM, 1 was stillborn, 3 with fatal manifestations of hydrops fetalis and died within 24 hours after birth. Autopsies of these patients showed blast cell infiltration of the heart and liver with related organ fibrosis.21 Two large studies reported incidences of TAM with hydrops fetalis of approximately 5-6% with life-threatening symptoms and early death after birth.4,5 In our study, 1 patient (3.1%) had hydrops fetalis after birth and died from severe sepsis at 28 days. The number of patients with hydrops fetalis in our study was slightly lower than in other reports.
Thalassemia in Asia 2021 Thalassemia in Brunei Darussalam
Published in Hemoglobin, 2022
Seow-Chin Chong, Sofian Metassan, Noorainun Yusof, Roserahayu Idros, Norehan Johari, Ihsan N. Zulkipli, Hazim Ghani, Mei-Ann Lim, Surita Taib, Zen-Huat Lu, Mas R.W. Abdul-Hamid
Aside from the above mentioned approaches of diagnosis, various molecular techniques have been introduced and employed to facilitate precise diagnosis and contribute to a deeper understanding of the underlying genetic mechanisms behind the diseases [20]. It is critical that individuals who may be asymptomatic and carry these genes are identified so they may be offered genetic counseling on their risks, the nature of the disease and their reproductive choices [21]. Most of the mutations instigating the thalassemia have been characterized and thus, polymerase chain reaction (PCR)-based techniques are widely employed to directly detect mutations in laboratories [22]. Unknown or rare mutations can also be identified by amplification and sequencing methods [23]. Additionally, prenatal genetic screening by methods such as chorionic villus sampling (CVS) and prenatal ultrasound allows identification of affected fetuses. This will facilitate parents’ decisions in such cases and also management of pregnancy and intervention in cases of non-immune hydrops fetalis [24]. However, prenatal screening for thalassemia and hemoglobinopathies is not available in Brunei.
Perinatal outcomes of intrauterine transfusion for foetal anaemia due to red blood cell alloimmunisation
Published in Journal of Obstetrics and Gynaecology, 2020
Ayşe Özge Şavkli, Berna Aslan Çetin, Zuat Acar, Zeynep Özköse, Mustafa Behram, Sema Süzen Çaypinar, Ahmet Tayyar, Mehmet Aytaç Yüksel
The survival rate is lower in patients with hydrops fetalis because of the technical problems in the transfusion procedure and the late referral of such cases. In their study, Pasman et al. (2015) found that the rate of hydrops fetalis was 12%. In Van Kamp et al.’s (2004) study, which was conducted between 1988 and 1999, the rate of hydrops fetalis was 21%, and the survival rate was 86%. The comparison of groups with and without hydrops fetalis showed that the survival rate of patients with hydrops fetalis was 78% and the survival rate of patients without hydrops fetalis was 92%, which was a significant difference. Hydrops fetalis was presented in 33.3% (14/42) of the cases and in 46.3% (51/110) of the procedures before transfusion. The greater number of hydrops fetalis cases was because the hospital is a perinatology referral centre, and most of the patients were referred from other centres. In this study, the survival rate of the patients with hydrops fetalis was 64.3%, and the survival rate of the patients without hydrops fetalis was 89.3%. The survival rate was lower in the foetuses with hydrops fetalis. In patients with hydrops fetalis, the targeted haematocrit value was not reached by a single transfusion but by gradually increasing the haematocrit value. Foetal death is sometimes unrelated to the procedure itself, and it depends on the underlying pathology, as in severe anaemic foetuses and in hydropic foetuses.