Understanding Hydrops Fetalis

A woman's pregnancy is a wonderful journey. In this journey, their bodies change to support the growing baby. While most of these changes are normal, certain conditions can make it more challenging. One such condition is hydrops fetalis that occurs in the baby’s body before or shortly after birth. It is a life-threatening condition. Thus, every parent should understand the early signs. This will ensure timely support for both the mother and the baby. For those trying to understand this condition, this blog walks you through the symptoms, causes, risks and treatment options. 

What is Hydrops Fetalis?

Hydrops Fetalis, also known as fetal hydrops, is a serious health concern. In this condition, an excessive amount of fluid builds up inside the body of an unborn or newborn. This fluid builds up in any part of the body; however, it is most commonly found in the abdominal area, under the skin and near the heart or lungs. When this condition is not treated in time, it can cause stress on the baby's heart and other organs.  

Symptoms of Hydrops Fetalis?

The baby’s symptoms can vary; however, the following are the most common signs:

During pregnancy:

• More amniotic fluid than usual
• Thick placenta
• Enlarged heart and spleen

After pregnancy:

• Pale skin
• Excessive sweating
• Breathing issues
• Enlarged liver
• Heart failure
• Anemia
• Jaundice
• Total body swelling

Types and Causes of Hydrops Fetalis

The following are two types and causes of this condition:

Non-immune Hydrops Fetalis

This is the most common type of this condition, and it makes up about 80-90% of all cases. It occurs if there is some underlying problem with the regulation of the body’s fluids. These underlying conditions include genetic, structural, infectious diseases, and heart or lung problems.

Immune Hydrops Fetalis

This is one of the rarer types of this condition. It happens due to the interaction between the blood of the mother and the fetus. This usually happens when there is a variation in the Rh blood factor. In such cases, the mother’s immune system identifies the blood cells in the fetus as foreign. It then starts producing antibodies to counteract this, which in turn leads to problems for the fetus.

Other Causes of Hydrops Fetalis

The following are some other common causes of this condition:

Severe Anaemia

Severe anaemia is a condition that occurs when the baby lacks the required number of healthy red blood cells necessary for the transportation of oxygen around the body. This lack of oxygen may hinder the functioning of the body, thus causing fetal hydrops.

Infection

Infections during pregnancy or at birth can, in some cases, result in fetal hydrops. Infections, which may be caused by viruses, bacteria, or parasites, can affect the normal development of the fetus and the regulation of fluids in the body. Infections can also compromise the immune system or vital organs, thus raising the risk of other health complications.

Birth Defects and Congenital Anomalies

Birth defects refer to problems that occur during pregnancy but are observed during birth. This is also known as congenital anomalies. The problems can vary in severity and may involve different organs such as the heart, lungs, and kidneys. The functioning of these organs is important to ensure that there is a proper balance of fluids within the body. When there is an imbalance, it may cause fetal hydrops.

Liver Disease

Another cause of this condition is liver disease in an unborn baby. The liver is responsible for controlling proteins and fluids in the body. When it does not function well, it leads to fetal hydrops. When such a disease occurs, it results from other conditions such as infections, genetic conditions, and other medical conditions.

Pregnancy Risks and Health Complications of Hydrops Fetalis

The following are some health complications this condition may cause:

Miscarriage, Premature Birth, and Stillbirth

This condition can lead to major health concerns during pregnancy and after birth. It can cause miscarriage, which is when the pregnancy ends on its own. It can also cause premature birth, which is the baby being born earlier than its due date. In a premature birth, the baby may not be fully developed. In some cases, it may lead to stillbirth, especially if the condition is not detected or managed early with proper medical care.

Mirror Syndrome in Mother

In some cases, the mother may develop a rare condition called mirror syndrome. It causes swelling, high blood pressure, and fluid retention, similar to the baby’s condition. This can become serious if untreated and may require close monitoring or early delivery for safety.

Developmental Delays

Babies who survive this condition may face issues in their growth and development as they get older. This delay can affect how they speak, move or interact with people around them. These delays may vary in how severe they can be, depending on how the baby is doing. 

Chronic Lung Damage

Since this condition can affect the lungs, it can lead to long-term breathing problems. It can cause difficulty in breathing for the baby before and after birth, which results in chronic lung damage. Children with such health issues need constant monitoring and medical care. They would also need oxygen support and medication.  

Diagnosis of Hydrops Fetalis

To understand the patient’s condition better, doctors may recommend several specialised tests during pregnancy. These help assess the baby’s health, detect abnormalities, and guide further treatment.

• Amniocentesis: This procedure involves removing a small amount of amniotic fluid, which is then used to test for infection or other abnormalities.
• Fetal Blood sampling: This procedure is used to diagnose conditions, including anaemia, infection, or abnormalities in the blood.
• Fetal Echocardiogram: This involves the use of ultrasound technology to evaluate the fetus’s heart and diagnose abnormalities.
• Genetic Testing: This procedure is used to diagnose chromosomal or genetic abnormalities, which may be associated with fetal hydrops.
• Fetal MRI: This is an imaging test that will give a better view of the organs in the fetus and any fluid build-up.
• Blood Tests: This includes tests for the mean corpuscular volume (MCV) and viruses that could be affecting the fetus.

Treat of Hydrops Fetalis

Treatment for this condition depends on the underlying cause and the severity of the condition. In some cases, care can begin during pregnancy, while in others, treatment is provided after birth.

During pregnancy, treatment may include:

• Fetal Blood Transfusion: Red blood cells are given to the fetus through the umbilical cord to treat severe anaemia.
• Antiarrhythmic Medicines: Medicines can be given to the mother to treat abnormal heartbeats in the fetus through the placenta.
• Shunt Placement: A small tube can be placed to drain excess fluid from around the lungs of the fetus.
• Fetal Surgery: In certain cases, a surgical procedure is performed to alleviate a specific condition, such as removing a tumour.

After birth, treatment may include:

• Caesarean Delivery: The baby can be delivered through Caesarean section if urgent medical care is required. 
• Ventilator Support: The baby may need help breathing and may need to be placed on a machine that can help it breathe. 
• Blood Transfusion: The baby may need blood transfusions, especially if the cause of hydrops is immune system-related.

Conclusion

Hydrops fetalis is a complex condition that can have serious effects on both the baby and the mother. However, early detection, proper diagnosis, and treatment can make a significant difference in managing the condition. Expecting parents should have regular prenatal check-ups and medical guidance to reduce risk. 

While seeking medical care is important, being financially prepared is equally important. Such check-ups and treatment can be costly. Thus, having a reliable health insurance plan is important. This helps in having access to quality healthcare without any added stress. 

Those living abroad who are looking for medical support in India or NRIs having their loved ones back at home should explore options like the Niva Bupa NRI Health Insurance plan. Such a plan ensures individuals get financial protection and access to comprehensive medical services.  

FAQs

1. What is the life expectancy of a baby with hydrops fetalis?

This is a critical condition, and it may affect the survival of a baby. In addition to that, many such cases may result in miscarriage. Of all the babies that are born, only a few may survive beyond the first year of life. On average, the survival rate is estimated to be between 20-30%. However, this may vary depending on the cause, detection, and treatment.

2. How quickly does hydrops fetalis develop?

This may occur at various stages in the pregnancy process. While in some cases, fetal hydrops may occur early in the process, in other cases, it may occur later.

3. Does fetal hydrops pose a risk to the mother?

Yes, in some cases, this condition may also affect the health of the mother. They might suffer from miscarriages, premature birth, mirror syndrome and other health risks.

4. How early can hydrops fetalis be detected?

This condition is often detected during routine pregnancy scans. It is most commonly detected during the second or third trimester of pregnancy, which is done with the help of an ultrasound scan. However, it can be detected earlier if there are early symptoms. This helps the doctors decide the course of treatment.

5. Can hydrops fetalis be prevented during pregnancy?

Prevention of this condition largely depends on the cause of hydrops. In cases of hydrops due to blood group incompatibility, a medication called RhoGAM can be used. This medication, which is in the form of a shot, is administered to the mother at risk. It prevents the immune system from attacking the red blood cells of the baby. However, there are certain cases of hydrops that cannot be prevented, but proper prenatal care can help.