Infection Prevention and Control

Biography

Biography: Ganga S. Pilli

Abstract

Introduction: Hydrops fetalis is a severe fetal condition characterized by an abnormal collection of fluid in pleural, peritoneal and pericardial cavities. Hydrops can result from diverse etiologies. It has been classically divided into immune and nonimmune hydrops. Determining the cause can save the fetus in subsequent pregnancies.

Case Report: A 22 years old female, multi-gravida presented with five months amenorrhoea.

Antenatal ultrasound scan was performed which revealed evidence of generalized edema of whole body of fetus.  She gives history of a non - consanguineous marriage.  Per-abdominal examination revealed 19 weeks and 5 days gestation. Ultrasound examination showed single intrauterine gestation. Amniotic fluid was adequate. Generalised subcutaneous edema was noted. Fetal parameters were noted and final impression was intrauterine death with hydrops fetalis. Maternal laboratory findings were within normal limits. Her blood group was “B positive” and husband’s blood group was “AB positive”. Antibody screening test was negative. Maternal serum titres for toxoplasmosis, rubella, cytomegalovirus, parvovirus, syphilis were negative. Medical termination of pregnancy was done was done and a still born fetus was delivered which was sent to the department of pathology for fetal autopsy.

Material and Methods: Fetus of 19 weeks 5 days gestation with placenta and attached umbilical cord was received for autopsy. A incision of Y shaped was taken and autopsy was performed. Thorax and abdominal cavity were opened in layers. Fluid was noted in thoracic and abdominal cavity amounting to 3cc and 8cc respectively. Fluid accumulation was also noted in the subcutaneous tissue. All the organs were found in situ. Heart and other organs did not reveal any anomalies.  Organs were examined histopathologically. Skin and subcutaneous tissue revealed excess accumulation of fluid and vessels showed nucleated RBCs. No viral inclusions were noted. Placenta was un remarkable. No other cause could be identified. Final impression of a female fetus with 19 weeks 5 days of gestation with non-immune hydrops fetalis without any congenital anomalies was given.

Conclusion: To conclude, a post-mortem evaluation should be performed in all cases of hydrops fetalis that result in neonatal death. A combined approach of a thorough antenatal assessment and autopsy may be more likely to determine the cause of non-immune hydrops.