Abstract
Hydrops fetalis is the abnormal accumulation of fluid in two or more different fetal compartments and most times associated with polyhydramnios and placental edema, and has an estimated incidence of about 1 in 3000 pregnancies. A 27-year-old multigravida; G8P7, was referred for the first ultrasonography in the Index pregnancy on account of not feeling/observing fetal movement for about two-weeks. The obstetric ultrasonography demonstrated a single fetus with absent fetal heartbeat, in hyper-flexed position, accumulation of fluid in the abdominal cavity; right sub-diaphragmatic region and in the right pleural cavity in keeping with fetal ascites and fetal effusion. There is overriding of fetal skull with Thickened/edematous placenta with a thickness of about 7cm, and fetal skin thickness of about 10mm. There is associated intrafetal gas. The estimated femoral length gave a gestational age approximating 41-weeks. A diagnosis of hydrops fetalis most likely non-immune form with fetal demise presenting at 41-weeks gestational age in a multiparous woman with features anemia presumably from sepsis and urinary tract infection (bilateral pyelonephritis and cystitis) in a setting of poor antenatal care was entertained. The fetus was expelled following induction of labor at the peripheral centre, the patient had transfusion done with commencement of antibiotics for correction of anemia and sepsis with plans of further clinical and laboratory evaluation. We present the ultrasonographic features of hydrops fetalis with intrauterine fetal demise due to its unique presentation
Highlights
Hydrops fetalis (HF) is a term for the abnormal accumulation of fluid in at least two different fetal compartments [1, 2]
Hydrops fetalis is most times regarded as a fatal condition and diagnosed following ultrasonography, and in most cases occurs in rhesus alloimmunization especially before prophylactic anti-D administration in the developed countries, an entirely different scenario may be encountered in the developing nations [4]
Hydrops fetalis has been classified into two forms; the iso-immune HF and the non-immune HF
Summary
Hydrops fetalis (HF) is a term for the abnormal accumulation of fluid in at least two different fetal compartments [1, 2]. Hydrops fetalis is most times regarded as a fatal condition and diagnosed following ultrasonography, and in most cases occurs in rhesus alloimmunization especially before prophylactic anti-D administration in the developed countries, an entirely different scenario may be encountered in the developing nations [4]. Hydrops fetalis occurs following an imbalance in the regulation of fluid leading to an increase in interstitial fluid production or a decrease in lymphatic drainage, these leads to accumulation of fluid in fetal soft tissues and serous cavities [8]
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