Hydrops fetalis

• Rh disease is an increasingly uncommon cause of immune-mediated hydrops fetalis. Due to preventative methods developed in the 1970s, the incidence of Rh disease has markedly declined. Rh disease can be prevented by administration of anti-D IgG (Rho(D) Immune Globulin) injections to RhD-negative mothers during pregnancy and/or within 72 hours of the delivery. However, a small percentage of pregnant mothers are still susceptible to Rh disease even after receiving anti-D IgG (Rho(D) Immune Globulin)

The non-immune form of hydrops fetalis has many causes including:[3]

• Iron deficiency anemia
• Paroxysmal supraventricular tachycardia resulting in heart failure
• Deficiency of the enzyme beta-glucuronidase. This enzyme deficiency is the cause of the lysosomal storage disease called mucopolysaccharidosis type VII.
• Congenital disorders of glycosylation
• Parvovirus B19 (fifth disease) infection of the pregnant woman
• Cytomegalovirus in mother
• Congenital pulmonary airway malformation (formerly called congenital cystic adenomatoid malformation)
• Maternal syphilis and maternal diabetes mellitus
• Alpha-thalassemia can also cause hydrops fetalis when all four of the genetic loci for α globin are deleted or affected by mutation. This is termed Hb Barts (consists of y-4 tetramers).
• Uncommonly, Niemann-Pick disease Type C (NPC) and Gaucher disease type 2 can present with hydrops fetalis.
• Turner syndrome
• Tumors,[4] the most common type of fetal tumor being teratoma, particularly a sacrococcygeal teratoma.
• Twin-twin transfusion syndrome in pregnancies in which twins share a single placenta (hydrops affects the recipient twin)
• Maternal hyperthyroidism
• Fetal cardiac defects and skeletal defects
• Noonan syndrome
• Mirror syndrome, in which fetal and placental hydrops develops in association with maternal preeclampsia, edema and hypertension
• Down syndrome