Non-Immune Hydrops Foetalis due to Congenital Toxoplasmosis: a rare case report with review of literature.

Mallikarjun A Pattanashetti ,Vijayalaxmi V Suranagi,Hema B Bannur

doi:10.21276/apalm.1077

Abstract

Non-Immune Hydrops Foetalis (NIHF) implies an excess of total body water which manifests as extracellular accumulation of fluid in serous cavities and soft tissues of foetus without any detectable circulating antibody against RBC antigen. Toxoplasmosis is an important congenitally acquired infectious cause of NIHF.Mother had complaints of fever, reduced foetal movements, USG showed hydrops foetalis and she tested positive for Toxoplasma IgG antibodies. On autopsy, foetus had generalised subcutaneous oedema, bilateral hypoplastic lungs with pleural effusion and oedema of brain with ventriculomegaly suggestive of hydrocephalus. We report a rare case of NIHF due to congenital toxoplasmosis with bilateral hypoplastic lungs, with emphasis on epidemiology and prevention of toxoplasmosis. DOI: 10.21276/APALM.1077

Highlights

Non-Immune Hydrops Foetalis (NIHF) is an excess of total body water evident as extracellular accumulation of fluid in soft tissues and serous cavities of foetus without presence of identifiable circulating antibody against Red Blood Cell (RBC) antigen
We report a case of NIHF due to congenital toxoplasmosis with hydrocephalus and bilateral hypoplastic lungs for its rarity in India with emphasis on epidemiology and prevention of toxoplasmosis
Congestion and oedema of brain with ventriculomegaly suggestive of hydrocephalus was evident [Figure 3]. This case was diagnosed based on clinical history, autopsy examination of foetus and serological tests for toxoplasma gondii infection in mother

Summary

Introduction

Non-Immune Hydrops Foetalis (NIHF) is an excess of total body water evident as extracellular accumulation of fluid in soft tissues and serous cavities of foetus without presence of identifiable circulating antibody against Red Blood Cell (RBC) antigen. The mother was a known case of Rh negative pregnancy with no Anti-D given after first delivery of healthy male baby weighing 2.5 kg. IgM antibodies - 0.1 IU/L (Negative < 0.8 IU/L ) both done by ELISA method. Foetus weighed 600 grams with generalised subcutaneous oedema of skin [Figure 1]. Congestion and oedema of brain with ventriculomegaly suggestive of hydrocephalus was evident [Figure 3]. This case was diagnosed based on clinical history, autopsy examination of foetus and serological tests for toxoplasma gondii infection in mother

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