Associated symptoms
As already mentioned, the fetus has fluid accumulations in the body. These are often water accumulations in the abdominal cavity (ascites) or between the lungs and the chest wall (pleural effusion). Another symptom is an increased amount of amniotic fluid (polyhydramnion). Furthermore, the affected fetus often suffers from weakness of the heart. After birth, the children are conspicuous by neonatal jaundice, anaemia and water retention.
Therapy of the Hydrops fetalis
In the treatment of fetal hydrops the focus is on the cause. Normally, it is caused by fetal anemia, which can be treated in the womb by a blood transfusion through the umbilical cord. If a fetofetal transfusion syndrome, which causes an uneven distribution of blood between the children, is the cause of the hydrops, the connection in the blood circulation of the twins can be closed again by laser coagulation.
If the cause of Hydrops fetalis is a disease with a poor prognosis of the child, it is very important to have a conversation with the treating doctor. The doctor can talk to the parents about the risks for mother and child and also about the therapeutic options and advise them. Under certain circumstances an abortion can be considered.
If a Hydrops fetalis is not treated, this can have consequences not only for the child. The mother may develop maternal hydrops syndrome, which is similar to pregnancy poisoning. After the birth of a child with Hydrops fetalis, the child must receive intensive medical care.
The affected children are often given artificial respiration. They also receive blood transfusions and are treated for neonatal jaundice by means of phototherapy or blood exchange. Fluid accumulations can be treated with a puncture for relief.Subsequently, the course of therapy depends on the causative disease.
What are the chances of survival and prospects for a normal life?
Thanks to modern diagnostic and therapeutic options, approximately 85 percent of children suffering from hydrops fetalis of immunological origin can survive. However, if the cause is non-immunological, fetal mortality can exceed 80 percent. In the first trimester of pregnancy, hydrops fetalis often leads to a spontaneous miscarriage.
During the third trimester, premature birth, atonic secondary bleeding and placental abruption occur more frequently. In living fetuses it is very likely to find the cause of the disease. In rare cases, repeated ultrasound examinations may reveal spontaneous regression of fetal hydrops.
Likewise, slight fluid accumulations may disappear of their own accord after birth. However, in severe cases, termination of pregnancy is recommended as soon as the mother’s health is at risk. After birth, artificial respiration is often necessary to ensure the survival of the affected child. Whether a positive course of the disease will occur cannot usually be predicted by the treating physician.
