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DefinitionAscites is the buildup of fluid inside the peritoneal cavity. It occurs when fluid moves out of the vascular system faster than the peritoneal lymphatics can remove it. This fluid shift is most commonly seen in liver cirrhosis but can also appear in several other systemic disorders.EtiologyCirrhosis remains the leading cause of ascites. Other conditions that can contribute include:Heart failureConstrictive pericarditisAbdominal cancersNephrotic syndromeSevere protein–calorie...
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Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
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A hydraulic jump is a sudden rise in fluid depth in open channels, occurring when high-velocity (supercritical) flow transitions to low-velocity (subcritical) flow. This phenomenon requires an upstream Froude number greater than 1, as flows with Fr1<1 remain subcritical, making a hydraulic jump impossible due to the need for negative head loss, which violates thermodynamic principles.The characteristics of a hydraulic jump depend on the upstream Froude number and are classified as...
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Portal hypertension is an increase in blood pressure within the portal venous system. Normally, this pressure is less than 5 mmHg. It is considered clinically significant when it rises above 10 mmHg. At this threshold, complications from altered blood flow and venous congestion emerge.EtiologyPortal hypertension arises from conditions that impede blood flow through the liver. The most common cause is cirrhosis, in which chronic liver injury leads to fibrotic scarring. This fibrosis narrows or...
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Endothelialized Microfluidics for Studying Microvascular Interactions in Hematologic Diseases
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The many faces of hydrops.

S Christopher Derderian1, Cerine Jeanty1, Shannon R Fleck2

  • 1Fetal Treatment Center, The University of California, San Francisco, CA, United States; Department of Surgery, The University of California, San Francisco, CA, United States.

Journal of Pediatric Surgery
|January 20, 2015
PubMed
Summary

Fetal hydrops survival depends on the underlying cause and gestational age at delivery, not fluid distribution. Fetal therapies and cardiovascular profile scores can aid prognosis in hydropic fetuses.

Keywords:
Cardiovascular profile scoreFetal echocardiographyFetal ultrasonographyHydropsHydrops fetalis

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Area of Science:

  • Perinatology
  • Fetal Medicine
  • Neonatology

Background:

  • Fetal hydrops is a serious condition with multiple causes and a poor prognosis.
  • Understanding predictors of survival is crucial for antenatal management.

Purpose of the Study:

  • To identify antenatal predictors of survival in hydropic fetuses.
  • To evaluate the role of anatomic and physiologic factors in fetal hydrops prognosis.

Main Methods:

  • Retrospective review of fetal ultrasounds and echocardiograms from 1996-2013.
  • Analysis of survival rates and influencing factors in 167 hydropic fetuses.
  • Categorization based on cardiothoracic ratio (CTR) and assessment of cardiovascular profile score.

Main Results:

  • Overall neonatal survival was 44%, influenced by the underlying disease.
  • Resolution of hydrops and later gestational age at delivery predicted survival.
  • Cardiovascular profile score was predictive of survival in fetuses with a high CTR.

Conclusions:

  • Survival in fetal hydrops is primarily determined by the underlying disease, fetal therapies, and gestational age at delivery.
  • Anatomic fluid distribution is not a significant predictor of survival.
  • Cardiovascular profile score may offer prognostic value in specific subgroups of hydropic fetuses.