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Non-immune hydrops fetalis: Two case reports.

Marianna Maranto1, Valentina Cigna2, Emanuela Orlandi2

  • 1Fetal Medicine and Prenatal Diagnosis Unit, Villa Sofia Cervello Hospitals, Palermo 90146, Italy. marianna.maranto@community.unipa.it.

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|August 26, 2021
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Summary

Fetal hydrops, often caused by maternal autoantibodies or infection, requires prompt diagnosis and management. Early intervention and appropriate obstetric care improve fetal survival rates and reduce long-term complications.

Keywords:
Case reportCordocentesisFetal anemiaFetal transfusionHydrops fetalisPreterm cesarean section

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Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Neonatology

Background:

  • Fetal hydrops, characterized by fluid accumulation, has shifted from Rh incompatibility to non-immune causes.
  • Etiologies are diverse, including infections, cardiac issues, chromosomal abnormalities, and autoimmune conditions, with pathogenesis often unclear.

Observation:

  • Two cases illustrate hydrops fetalis: one with suspected infection and severe fetal anemia requiring transfusions and early delivery, and another with Sjogren's syndrome and maternal autoantibodies causing fetal anemia and hydrops.
  • Both cases involved fetal anemia necessitating transfusions and ultimately preterm delivery via Cesarean section.

Findings:

  • Infectious etiology should be considered even with inconclusive tests if clinical suspicion is high.
  • Transplacental passage of maternal autoantibodies (e.g., Anti-Ro/SSA) can lead to fetal anemia and hydrops fetalis.

Implications:

  • Determining the underlying cause of fetal hydrops is crucial for targeted treatment.
  • Optimal obstetric management, balancing risks and benefits for delivery timing, is essential for improving fetal outcomes and minimizing sequelae.