Diagnostic ultrasound ( PDFDrive )

1430 PART IV Obstetric and Fetal Sonography
A B C
D
E
F
Chest
A
G
H
I
FIG. 41.26 Turner Syndrome in First and Second Trimesters. (A) Fetus at 12 weeks with diffuse skin thickening and lymphangiectasia. (B)
and (C) Fetus at 13 weeks with nuchal thickening and diffuse body wall edema. (D)-(G) Fetus at 18 weeks with cystic hygroma and pleural effusion
and diffuse body wall edema. (H) and (I) Fetus at 19 weeks with cystic hygroma (arrow) and ascites (A).
oten unclear why hydrops develops. here are a few reports of
transient abnormal myelopoiesis with trisomy 21 as a cause of
hepatomegaly and nonimmune hydrops. 137,138 In these cases,
PUBS demonstrates fetal anemia and hypoalbuminemia. A
hydropic fetus with multiple structural anomalies, prominent
cystic hygromas, or increased nuchal translucency likely has a
chromosomal abnormality. he physiologic basis for increased
nuchal translucency is incompletely understood, but it may be
caused by delayed lymphatic development and/or related to
cardiovascular malformations, 139 especially in cases with
aneuploidy. 140
Tumors
Arteriovenous malformations and arteriovenous shunting in
large tumors with a high proportion of solid tissue lead to hydrops
by causing high-output cardiac failure and leading to Kasabach-
Merritt sequence (consumptive coagulopathy). Selected fetuses
with tumors, such as large sacrococcygeal teratoma associated
with hydrops, have undergone in utero procedures, including
cyst aspiration and open fetal surgical resection. However, these
procedures are complicated by preterm delivery and other
obstetric complications. 141 More recent reports suggest improved
outcomes with laser ablation or alcohol sclerosis targeting the