Hydrops fetalis is considered a severe and life-threatening condition that can affect fetuses or newborn babies. If the newborn or unborn baby is diagnosed, even with treatment more than half of the babies will die shortly before or after delivery.
What is Hydrops Fetalis?
Hydrops fetalis is abnormal amounts of fluids that accumulate in two or more body parts of the baby. This fluid buildup can occur anywhere in the body but in most cases, it occurs in the lungs, abdomen, heart or even under the skin of the baby. Hydrops fetalis is not actually a disease but a symptom of an underlying health condition from which the baby may be suffering from. If not treated then hydrops can stress the baby’s vital organs and lead to life-threatening complications.
Can a baby survive fetal hydrops?
The severe swelling which occurs with hydrops can overwhelm the baby’s organ systems. About 50% of unborn babies with hydrops don’t survive. Risks for other problems are also high for babies born with hydrops so, survival often depends on the cause and treatment.
Causes of Hydrops Fetalis
Immune
This occurs when there is an rh-incompatibility between the fetal and mother’s blood. If the fetus’ blood is rh-positive and the mother’s blood is rh-negative, the mother’s blood treats the baby’s blood as invaders and sends out antibodies to fight it. Extreme cases of rh-incompatibility can cause immune hydrops.
Non-immune
It is more common and occurs when some kind of disease or ailment hampers with the body’s ability to regulate fluids. Some of the health conditions that can lead to non-immune hydrops fetalis such as chromosomal abnormalities, congenital infections, severe anaemia etc.
Symptoms of Hydrops Fetalis
- Severe swelling in the baby’s abdomen
- Bruising
- Pale skin
- Severe jaundice
- Difficulty in breathing
- Enlarged spleen or liver
Diagnosis
Ultrasound
Doctor can conduct an ultrasound scan to examine the unborn baby’s organs, tissues and blood vessels. This test or hydrops fetalis ultrasound will help the doctor in establishing how the blood is flowing in different parts of the baby’s body.
Amniocentesis
This process involves extracting some amniotic fluid around the baby to test for any complications.
Fetal blood sampling
Blood sampling is invasive and requires inserting a needle through the mother’s uterus and into one of the baby’s blood vessels of the umbilical cord.
Treatment
The treatment depends on the cause of hydrops fetalis and if no evident cause is establishes, the doctor may suggest measures to ease the symptoms. Hydrops fetalis cannot be treated before the birth of the baby. In many cases, the doctor may opt for blood transfusion to increase the chances of a baby’s survival at birth. However, the doctor may even opt for delivering early. After the birth of the baby, treatment options are –
- Use of medicines that may decrease the chances of heart failure
- Use of ventilators to give breathing support for the baby
- Use of medicines to helps in getting rid of excess fluid from the kidneys
- Use of a needle to remove excess fluid around the heart, abdomen or lungs of the baby
Complications
Severe swelling in babies’ internal organs can lead to overwhelming the basic functioning of the organs. The hydrops fetalis survival rate is approximately 20 %, therefore, if this condition is detected in babies, correct treatment measures must be taken at the earliest to increase the chances of successful pregnancy after hydrops. The complications that may arise if treatment is not done on time are –
- The baby may have underdeveloped lungs due to excess fluids and swollen organs may leave less space in the chest.
- The baby may have higher chances of developing low blood sugar which can cause the baby at the risk of brain injuries or seizures.
- The baby may develop respiratory distress or severe breathing difficulty.
- The baby may be born prematurely due to excessive amniotic fluid.
- The baby’s heart function or breathing may get affected due to excess fluid around the heart and the lungs.
- In some cases, this condition may lead to fetal deaths.
Conclusion
Any kind of complication can be scary during pregnancy and hydrops is undoubtedly a serious medical condition that can affect babies. Ensure to get regular check-ups and seek medical attention to manage and reduce the risk of complications that may arise due to hydrops fetalis.
References –
- hydrops fetalis – statpearls – ncbi bookshelf (nih.gov)
- hydrops fetalis | genetic and rare diseases information center (gard) – an ncats program (nih.gov)