Nonimmune Hydrops Fetalis Flashcards
Definition of hydrops fetalis …?
Hydrops fetalis has classically been defined as the presence of extracellular fluid in at least two fetal body compartments
Definition for fluid collection in hydrops featslis ..?
These fluid collections include skin edema (>5-mm thickness), pericardial effusion, pleural effusions, and ascites;
Frequent additional findings in USG Hydrops fetalis ..?
-polyhydramnios (deepest vertical pocket of amniotic fluid of >8 cm or amniotic fluid index >24 cm) and
-placentomegaly (>4-cm thickness in the second trimester or >6-cm thickness in the third trimester
The three most common disorders lysosomal storage disease in cases of NIHF …?
mucopolysaccharidosis type VII,
Gaucher’s disease, and
GM1 gangliosidosis
Most common cause for NIHF ….?
Cardiovascular-21.4%
Hypoplastic left heart, Ebstein anomaly, endocardial cushion defect, bradyarrhythmias/tachyarrhythmias (congenital heart block, SVT, atrial flutter)
Indication for serial intrauterine transfusion ..?
Fetal α-thalassemia with Bart’s hemoglobin and NIHF
Adenovirus and NIHF ….?
Adenovirus can cause fetal myocarditis with resulting hydrops.
Which bradyarrythmias are not treatable ..?
Ventricular rates of <50 bpm due to structural cardiac lesions or inflammation secondary to maternal anti-Ro antibodies are not amenable to therapy
Arrhythmia associated with NIHF…?
fetal atrial flutter and supraventricular tachycardia
Treatment for fetal SVT …?
Maternal administration of digoxin followed by the addition of flecainide or sotalol is usually successful in converting these to a sinus rhythm with subsequent resolution of NIHF.
Role of steroids in NIHF …?
In solid CCAM lesions with mediastinal shift and NIHF, maternal steroid administration has resulted in resolution of the hydrops
Risk NIHF in twin pregnancy …?
Twin–twin transfusion. The recipient twin can exhibit NIHF in cases of twintwin transfusion in up to 7% of cases
What is mirror syndrome …?
If placental hydrops is significant, an additional life-threatening complication has been described—Ballantyne’s syndrome (also known as mirror syndrome, triple edema, and pseudotoxemia)
What is EXIT procedure …?
EXIT procedure (ex-utero intrapartum treatment procedure or placental circulation resuscitation) gives more time to stabilize the neonate at birth
Fluid management in NIHF …?
Fluid management should be based on a calculated “dry weight” of the patient (usually the 50th percentile for the gestational age).
Maintenance intravenous fluids should start at 40 to 60 mL/kg/day of 10% dextrose solution and adjusted for serum glucose levels
