Hydrops Fetalis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Hydrops fetalis is a serious and life-threatening condition in the fetus and newborn.
This condition is characterized by a buildup of fluid in various parts of the body, such as in the abdominal cavity, and cavities outside the lungs, heart, and skin.
Based on the cause, there are two types of hydrops fetalis, namely:
Immune Hydrops
In this type, hydrops fetalis occurs due to an immune system reaction in the mother’s body that causes red blood cells in the fetus’s body to be destroyed excessively.
Non-immune Hydrops
The second type is more common. Non-immune hydrops occurs due to a disease in the fetus that causes it to be unable to maintain fluid balance in the body.
Hydrops fetalis often causes death. Death can occur when the baby is still in the womb, or when the baby is born.
Symptoms
Hydrops fetalis can be known while still in the womb, or after birth. Symptoms of hydrops fetalis that can be observed in the womb are:
- Amniotic fluid in the mother’s womb is much more than it should be
- The placenta is thickened
- Ultrasound results of the fetus showed that the heart, liver, spleen, and lungs of the fetus were swollen.
After the baby is born, the main symptoms of hydrops fetalis are:
- Swelling all over the body, especially the abdomen
- His skin looked pale
- The baby looks tight and has difficulty breathing
- The skin and eyes appear yellow
- Enlargement of the liver and spleen
- Bruised patches on the skin
Reason
In principle, hydrops fetalis occurs as a result of a lot of fluid originating from the bloodstream moving into body tissues, such as the skin, heart, lungs and stomach.
Immune hydrops occurs due to rhesus incompatibility disorder, which is a condition that occurs because a mother with a negative rhesus blood group contains a fetus with a positive rhesus blood group.
In this condition, because of a different blood type, the mother’s body will recognize the baby’s blood cells as foreign objects that must be destroyed. As a result, there is excessive destruction of the baby’s red blood cells.
Because of this, the heart of the fetus or baby becomes disturbed and cannot pump blood as it should. The fluid then accumulates in various parts of the body of the fetus or baby.
Meanwhile, non-immune hydrops can occur in babies who experience:
- Severe anemia, eg anemia caused by thalassemia
- Congenital disorders, eg congenital toxoplasma, syphilis, or congenital cytomegalovirus infection
- Congenital defects of the heart or lungs
- Kelainan Chromosome
- Liver disease
Diagnosis
Whether there is hydrops fetalis can be known since the baby is still in the womb. There are several tests to diagnose hydrops fetalis, namely:
- Ultrasound examination (USG) to see if there is a buildup of fluid in the internal organs of the fetus, as well as a buildup of fluid in the body cavities.
- Umbilical cord blood collection is done by sticking a needle into the mother’s uterus until it penetrates the umbilical cord. This is done to find out the possible causes of hydrops fetalis experienced by the baby.
- Amniocentesis, namely taking a sample of amniotic fluid (amniotic fluid) which is carried out by inserting a needle towards the mother’s uterus to penetrate the amniotic membranes. Furthermore, the amniotic fluid taken is analyzed in the laboratory to see the possibility of hydrops fetalis and its causes.
- Echocardiography, which is an examination of the inside of the heart, is needed because usually babies who experience hydrops fetalis also have abnormal heart structures.
Treatment
Hydrops fetalis can be detected since the baby is still in the womb. However, treatment, when the baby is still in the womb, cannot always be done.
Sometimes, doctors can give a fetus a blood transfusion to increase its chances of survival after birth. However, this transfusion is only done for some cases.
If hydrops fetalis is known while in the womb, pregnant women must be referred to a hospital that has complete facilities for newborns.
Furthermore, treatment should be carried out immediately after the baby is born. Actions that are generally performed when a newborn has hydrops fetalis, namely:
- Thoracentesis, which is inserting a needle into the baby’s chest cavity, to remove fluid buildup in the chest cavity which causes difficulty breathing.
- If the baby’s breathing is very disturbed, the installation of oxygen or a ventilator can be done when necessary.
- Administering drugs to treat heart failure, drugs to treat heart rhythm abnormalities (arrhythmic drugs), and to remove fluid buildup through the kidneys (diuretic drugs).
- Especially for immune type hydrops fetalis caused by rhesus incompatibility, babies will also get blood transfusions according to their own blood type.
- Surgery to correct congenital abnormalities in babies.
Prevention
Not all cases of hydrops fetalis can be prevented. However, the risk of hydrops fetalis due to rhesus incompatibility can be minimized.
For example, you are a woman with a negative rhesus blood type, have a partner with a positive rhesus blood type, and plan to have children.
Consult with your obstetrician first to assess the risks.
Complications
Babies who experience hydrops fetalis are at high risk of being born prematurely and even die if they are not treated promptly.