Fetal bradyarrhythmia causing hydrops fetalis: A journey from fetal echo to autopsy

Non-immune hydrops fetalis is a condition with poor fetal prognosis. The incidence of this clinical condition is increasing as compared to its iso-immune variant. The diagnosis of hydrops fetalis is straightforward; however, delineating the primary cause of non-immune hydrops fetalis requires a holistic approach and background knowledge of the entity.

We present a case of non-immune hydrops fetalis due to a rare functional cardiac disorder demonstrated by features of cardiac failure in the form of clinically significant tricuspid regurgitation detected on echocardiography. Fetal autopsy supported the diagnosis by excluding any structural anomaly.

Non-immune hydrops fetalis may be due to structural and non-structural cardiac anomalies. Meticulous work-up is required to establish the diagnosis in such cases.

The case also highlights the systematic approach as well as the series of investigations required for the early diagnosis and management of such cases.