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Endocardial fibroelastosis in infants with hydrops fetalis
M J Newbould1, G R Armstrong, A J Barson
1Department of Pathology, St. Mary's Hospital, Manchester.
Journal of Clinical Pathology
|July 1, 1991
Summary
Endocardial fibroelastosis, a thickened endocardium, was found in infants with hydrops fetalis. This condition may result from chronic prenatal myocardial stress, particularly in cases of intrauterine congestive heart failure.
Area of Science:
- Perinatal pathology
- Cardiovascular pathology
- Fetal development
Background:
- Endocardial fibroelastosis (EFE) is characterized by excessive endocardial thickening (>30 microns).
- Hydrops fetalis is a severe condition of fluid accumulation in fetus.
Purpose of the Study:
- To investigate the prevalence of EFE in cases of hydrops fetalis.
- To explore the potential link between EFE and intrauterine congestive heart failure.
Main Methods:
- Retrospective review of 1589 perinatal necropsies conducted between 1976 and 1989.
- Analysis of 34 cases of hydrops fetalis, including rhesus hemolytic disease and non-rhesus hydrops.
- Comparison with an age-matched control group without EFE.
Main Results:
- EFE was identified in 10 out of 34 hydrops fetalis cases (29.4%).
- Seven of 18 non-rhesus hydrops cases (38.9%) and 3 of 16 rhesus hemolytic disease cases (18.8%) had EFE.
- Intrauterine congestive heart failure was implicated in 80% of hydrops fetalis cases with EFE.
Conclusions:
- EFE is a significant finding in hydrops fetalis, particularly non-rhesus cases.
- Findings support the hypothesis that EFE is an endocardial response to chronic prenatal myocardial stress.
- Congestive cardiac failure is strongly associated with EFE in the perinatal period.