Potential etiology for non-immune fetal hydrops – considerations based on a clinical case

Abstract

Fetal hydrops is caused not only by a severe Rh incompatibility, but also by several other non-immune factors. Few tests may predict this occurrence during pregnancy, and there are even fewer treatment methods during intrauterine life, with low rates of success. Material and methods. We present a clinical case of a 30-week-gestation pregnancy with bilateral hydrothorax and polyhydramnios, without Rh incompatibility or chromosomal abnormalities. Results. A female newborn weighing 3000 g, with severe subcutaneous edema and bilateral hydrothorax, was extracted by C-section. The Apgar score was 1/1/0/0 despite intensive resuscitation. The pathology exam revealed bilateral hypoplastic lungs and hepatomegaly. Discussions . There are still some cases of unpreventable idiopathic fetal hydrops, but this diagnostic can only be made after ruling out many other etiologies. Conclusion . The key point for hydropic fast developing cases may consist in earlier detection by ultrasound and rigorous pregnancy follow-up, including parvovirus B19 determination and karyotype, to increase the chance of success for fetal thoracic drainage.