-
Clinics in Perinatology Mar 2020Nonimmune hydrops fetalis (NIHF) historically has been considered a lethal fetal condition. Understanding NIHF to be a symptom or an end-stage status of a variety of... (Review)
Review
Nonimmune hydrops fetalis (NIHF) historically has been considered a lethal fetal condition. Understanding NIHF to be a symptom or an end-stage status of a variety of fetal conditions, along with improved fetal diagnostics and interventions, has changed the landscape for at least some fetuses. Understanding the pathophysiologic mechanisms has led to the development of diagnostic algorithms, improved understanding of cause, and therefore fetal or neonatal treatments. Multidisciplinary counseling and shared decision making are critical to supporting families through pregnancy decisions, potential fetal therapeutic interventions, neonatal management decisions, and at times accepting or transitioning to palliative care.
Topics: Counseling; Decision Making; Diagnosis, Differential; Female; Humans; Hydrops Fetalis; Infant, Newborn; Pregnancy; Prenatal Diagnosis; Prognosis; Rare Diseases
PubMed: 32000919
DOI: 10.1016/j.clp.2019.10.001 -
Current Pediatric Reviews 2018Hydrops Fetalis (HF) or fetal hydrops is identified as an abnormal interstitial collection of fluid in at least 2 or more compartments of the fetal torso (peritoneal... (Review)
Review
DEFINITION
Hydrops Fetalis (HF) or fetal hydrops is identified as an abnormal interstitial collection of fluid in at least 2 or more compartments of the fetal torso (peritoneal cavity, pleura, and pericardium). An alternative definition discusses about liquor accumulation in two fetal anatomical areas or an effusion in one site and anasarca.
BACKGROUND
Parvovirus B-19 is a common childhood illness; the virus can cause fetal anemia, non-immune fetal hydrops, and spontaneous abortion and might lead to fetal demise. HF is the pathological distribution of body fluids between the interstitial and the intravascular areas of the fetus. Normally, in the fetal organism there is a continuous circular movement of the lymph from the interstitial space into the vascular system and vice versa. The detection of a solely effusion represents the initial stage of a systemic disorder that will lead to a fully developed hydrops or remain just a local disorder.
OBJECTIVE
The connection between parvovirus B-19 and fetal hydrops.
CONCLUSION
The view is unbeatable, severely swollen babies; immune hydrops is surfaced because of the maternal antibodies targeted against red blood cells with Rh positive antibody of the fetus, while the non-immune is due to a variety of pathological conditions in pregnancy.
Topics: Female; Fetus; Humans; Hydrops Fetalis; Infant, Newborn; Parvoviridae Infections; Parvovirus B19, Human; Pregnancy
PubMed: 30124157
DOI: 10.2174/1573396314666180820154340 -
Clinics in Perinatology Dec 2000Although most NIH fetuses have poor prognosis, it is imperative to attempt to identify the underlying cause to present parents with the best estimate for prognosis and... (Review)
Review
Although most NIH fetuses have poor prognosis, it is imperative to attempt to identify the underlying cause to present parents with the best estimate for prognosis and future outcomes. Identification of a disorder with a good prognosis may prevent unnecessary termination of pregnancy and give a chance for therapy. Identification of a disorder with poor prognosis may still provide information that may be unavailable after delivery regarding this and future pregnancies.
Topics: Counseling; Diagnosis, Differential; Female; Humans; Hydrops Fetalis; Pregnancy; Prognosis; Ultrasonography, Prenatal
PubMed: 11816486
DOI: 10.1016/s0095-5108(05)70061-0 -
Zeitschrift Fur Geburtshilfe Und... Apr 2017Cardiac etiologies of hydrops fetalis have been a topic of concern due to challenging perinatal management. The common cardiac etiologies leading to hydrops fetalis... (Review)
Review
Cardiac etiologies of hydrops fetalis have been a topic of concern due to challenging perinatal management. The common cardiac etiologies leading to hydrops fetalis include structural cardiac anomalies, cardiac dysrhythmias, cardiac tumors, cardiomyopathy and myocarditis. The mechanisms of cardiogenic hydrops fetalis may be: 1) elevation of atrial pressure and volume overload, 2) decrease of cardiac output, and 3) development of congestive heart failure. The diagnosis of hydrops fetalis was usually made at 19-36 gestational weeks, when ultrasound is a highly effective diagnostic method. Intrauterine interventions for certain congenital heart defects, maternal transplacental or direct fetal medications and fetal pacing placement for cardiac arrhythmias, and fetal or postnatal tumor resections are important progressions of etiologic treatment for hydrops fetalis. Treatment strategies for hydrops fetalis are usually ultrasound-guided pericardiocentesis and feto-amniotic shunting, whereas reaccumulation may require further interventions or postnatally. Hydrops fetalis often carries a poor prognosis, and mortality remains high. Current developments in the management of hydrops fetalis should encourage physicians to attempt further fetal interventions.
Topics: Arrhythmias, Cardiac; Delivery, Obstetric; Female; Heart Defects, Congenital; Heart Diseases; Heart Neoplasms; Humans; Hydrops Fetalis; Infant, Newborn; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prenatal Diagnosis
PubMed: 28561210
DOI: 10.1055/s-0042-123825 -
Clinics in Diagnostic Ultrasound 1989Sonography has a major role in the identification, evaluation, and treatment of the hydropic fetus. Although the prognosis of the NIH fetus is generally poor, the IIH... (Review)
Review
Sonography has a major role in the identification, evaluation, and treatment of the hydropic fetus. Although the prognosis of the NIH fetus is generally poor, the IIH fetus can frequently be treated effectively by transfusions performed by percutaneous needling of the umbilical vein. In addition, sonographic guidance of percutaneous umbilical vein sampling affords an accurate assessment of the etiology of NIH by facilitating karyotyping of the fetal blood.
Topics: Female; Fetal Diseases; Humans; Hydrops Fetalis; Pregnancy; Prenatal Diagnosis; Prognosis; Ultrasonography
PubMed: 2696546
DOI: No ID Found -
Nigerian Journal of Medicine : Journal... 2013Non-immune hydrops fetalis (NIHF) is a rare fetal condition with a very high mortality in spite of advances in prenatal diagnostic techniques, early detection, and... (Review)
Review
BACKGROUND
Non-immune hydrops fetalis (NIHF) is a rare fetal condition with a very high mortality in spite of advances in prenatal diagnostic techniques, early detection, and individualized management. Despite advancement in fetal therapy and rapidly developing new knowledge about the aetiology and prenatal diagnosis, its management has remained controversial.
METHODS
This is a descriptive review ofNIHF.
RESULTS
NIHF is a rare fetal condition that presents in an extremely acute manner with almost 90% mortality. Fetal cardiac anomalies are the most common cause and chromosome anomalies are the second-most-common cause. The worst prognosis was related to prematurity, severe hydrops, anaemia, cardiac malformations, chromosomal disorders and congenital infections. Fetal interventions includeboth medical and surgical modalities.
CONCLUSION
NIHF is a rare condition with high prenatal mortality. The exact pathophysiology is still poorly understood. It is important to detect NIHF early, diagnose the underlying cause and institute appropriate treatment. There is need for autopsy of all fetuses or neonates who die from NIHF.
Topics: Drainage; Humans; Hydrops Fetalis; Prognosis
PubMed: 24283082
DOI: No ID Found -
The Journal of Perinatal & Neonatal... Dec 1999Nonimmune hydrops fetalis (NIHF) is a term that defines an edematous fetus that does not have erythroblastosis fetalis from isoimmunization. All of the other reasons... (Review)
Review
Nonimmune hydrops fetalis (NIHF) is a term that defines an edematous fetus that does not have erythroblastosis fetalis from isoimmunization. All of the other reasons that a fetus develops NIHF are included in this category. The causes of NIHF range from diseases to structural anomalies to genetic abnormalities. The mere presence of NIHF is a poor prognostic indicator, even with the etiology unknown. Some causes of NIHF are treatable with intrauterine therapies. These currently include cordocentesis to administer intrauterine transfusions or medications and fetal surgery. Prenatal testing to establish an etiology or follow the progress of the fetus is extensive, expensive, and stressful. The mortality rate remains high. Education, counseling, and support of the patient and family are the work of the prenatal period. Delivery room management of the infant with NIHF requires a resuscitation team with a specific plan of care to maximize chances of survival.
Topics: Cordocentesis; Female; Fetal Diseases; Humans; Hydrops Fetalis; Infant, Newborn; Maternal-Child Nursing; Neonatal Nursing; Perinatal Care; Pregnancy; Prenatal Care; Prognosis; Resuscitation
PubMed: 10818859
DOI: 10.1097/00005237-199912000-00004 -
Neonatal Network : NN Oct 1988
Review
Topics: Female; Humans; Hydrops Fetalis; Infant, Newborn; Nursing Assessment; Pregnancy
PubMed: 3050444
DOI: No ID Found -
Neonatal Network : NN Sep 1999Hydrops fetalis is a relatively rare phenomenon that presents itself in the delivery room in an extremely acute manner. Prompt resuscitation, an understanding of the... (Review)
Review
Hydrops fetalis is a relatively rare phenomenon that presents itself in the delivery room in an extremely acute manner. Prompt resuscitation, an understanding of the condition and its presentation, and immediate treatment can make the difference between life and death in these cases. The focus of this article is on nonimmune hydrops, the type of hydrops seen in the clinical setting. Maternal and fetal pathophysiology, current theories, diagnostic evaluations, neonatal pathophysiology, clinical manifestations, treatment options, pertinent research, and the needs of the family are discussed.
Topics: Delivery, Obstetric; Diagnosis, Differential; Humans; Hydrops Fetalis; Infant, Newborn; Neonatal Nursing; Parents; Resuscitation
PubMed: 10690096
DOI: 10.1891/0730-0832.18.6.25 -
Seminars in Perinatology Aug 1994In summary, NIHF is a heterogenous disorder resulting from a vast number of underlying pathologies. A thorough evaluation should be performed in all cases to attempt to... (Review)
Review
In summary, NIHF is a heterogenous disorder resulting from a vast number of underlying pathologies. A thorough evaluation should be performed in all cases to attempt to establish the etiology. This requires a systematic approach that should logically proceed from least to most invasive testing. Despite increasing availability of treatment for some causes of NIHF, the prognosis for this condition in general remains poor. In cases of fetal or neonatal demise, autopsy should be encouraged to aid in confirming or making a diagnosis. It is especially important to rule out potentially treatable conditions, as well as genetic disorders with a risk of recurrence in future pregnancies.
Topics: Chromosome Aberrations; Diseases in Twins; Female; Heart Diseases; Hematologic Diseases; Humans; Hydrops Fetalis; Neoplasms; Pregnancy; Pregnancy Complications
PubMed: 7985044
DOI: No ID Found