Anemia of Prematurity - Portal Neonatal

Hydrops Fetalis
Last Updated: June 22, 2005
Synonyms and related keywords: hydrops foetalis, nonimmune hydrops, fetal edema, fetal
subcutaneous tissue edema, placental edema, hydramnios, maternal-fetal blood group
incompatibilities, maternal isoimmunization to fetal blood group antigens, isoimmune hemolytic
disease, immune hydrops, homozygous alpha-thalassemia, Bart hydrops, congenital
malformations, premature delivery, fetal fluid accumulations, fetal thoracentesis, fetal
paracentesis, fetal surgical procedures, maternal ABO-factor isoimmunization, Rh D hemolytic
disease, drug use, collagen disease, thyroid disease, diabetes, organ transplant, blunt abdominal
trauma, coagulopathy, use of teratogenic drugs, sexually transmitted diseases, hemoglobinopathy,
viral illness, fetomaternal transfusion, herpetic lesions, chancre, hemolytic disease of newborn,
erythroblastosis, glucose phosphate isomerase deficiency, pyruvate kinase deficiency, G-6-PD
deficiency, congenital dyserythropoietic anemia, Diamond-Blackfan syndrome, lethal hereditary
spherocytosis, spectrin synthesis defects, congenital erythropoietic porphyria, Günther disease,
leukemia with Down syndrome, leukemia with Noonan syndrome, Bart hemoglobinopathy,
Parvovirus B19, B19V, intracranial hemorrhage, intraventricular hemorrhage, hepatic laceration,
placental subchorial hemorrhage, sacrococcygeal teratoma, fetomaternal hemorrhage, twin-to-twin
transfusion, isoimmune fetal thrombocytopenia, fetal anemia, fetal aplastic anemia, malformation
syndromes, fetal hemorrhage, placental choriocarcinoma, placental chorangioma, partial placental
abruption, reduced fetal body movements, sinusoidal fetal heart rate patterns, fetal acardia, fetus
papyraceous, stuck twin, vanishing twin, velamentous cord insertion, atrial natruretic factor, fetal
meconium peritonitis, lysosomal storage disorders, cystic hygroma, cystic adenomatoid
malformation of the lung, fibroelastosis, prenatal closure of foramen ovale, prenatal closure of
ductus arteriosus, idiopathic arterial calcification, AV block, atrial flutter, tachyarrhythmia,
congenital heart block, maternal collagen disease, congenital syphilis, lethal multiple pterygium
syndromes, fetal coagulopathy, bronchopulmonary sequestration, tension hydrothorax
AUTHOR INFORMATION Section 1 of 10
Author: George Cassady, MD, Clinical Professor, Department of Pediatrics, Stanford University
School of Medicine
George Cassady, MD, is a member of the following medical societies: American Academy of
Pediatrics, American Pediatric Society, Society for Pediatric Research, and Southern Society for
Pediatric Research
Editor(s): David N Sheftel, MD, Director, Division of Neonatology, Lutheran General Children's
Hospital of Park Ridge, Clinical Associate Professor, Department of Pediatrics, Chicago Medical
School; Robert Konop, PharmD, Director, Clinical Account Management, Ancillary Care
Management; Arun Pramanik, MD, Professor, Department of Pediatrics, Division of Neonatology,
Louisiana State University Health Science Center; Carol L Wagner, MD, Associate Professor,
Department of Pediatrics, Division of Neonatology, Medical University of South Carolina; and Neil
N Finer, MD, Director, Division of Neonatology, Professor, Department of Pediatrics, University of
California at San Diego
INTRODUCTION Section 2 of 10
Background: Hydrops fetalis (ie, fetal hydrops) is usually defined as the presence of fetal
subcutaneous tissue edema accompanied by serous effusion(s) in 1 or more body cavities. As the
effects of gravity are blunted in the relatively weightless fetus, the edema is generalized, not
dependent. The fetus may accumulate a much greater excess of fluid than is possible after birth
because of key differences between fetal and postnatal circulations (eg, parallel flow vs serial flow,
low-resistance systemic circuit) and differences between the organs of gas exchange (placenta vs
lungs). The degree of edema observed in the fetus or newborn with hydrops is thus massive and
may appear grossly bloating and deforming to the clinician who is more accustomed to children or
adults. Placental edema invariably accompanies fetal edema, and hydramnios is usually present.