Hydrops fetalis caused by a blood group antibody usually undetected in routine screening.

A case of isoimmunisation in pregnancy caused by antibodies to the Kpa red blood cell antigen is described. The preceding pregnancy had resulted in fetal hydrops for which no cause was found as the antibody screening cells used to investigate the fetal hydrops were Kpa negative. This case emphasises the importance of serological screening at a reference laboratory for low frequency red cell antigens before a diagnosis of non-immune hydrops is made.     

Hydrops fetalis due to abnormal lymphatics.

A case of generalised lymphatic abnormality that presented with hydrops fetalis is described. This seems to be the first such case reported.     

Hydrops fetalis in South Korea

Excluding those with congenital syphilis all infants born in a hospital in South Korea with hydrops fetalis during a 47 month period were studied. In six out of a total of 17 cases no obvious abnormality was found. Abnormalities in the other cases included leukaemia, pulmonary cysts, ovarian cyst, haemangioma, peritonitis, limb contractures, left hypoplasia and maternal anaemia. The literature is reviewed and the pathophysiology discussed.     

Hydrops fetalis due to ABO incompatibility

Antenatal haemolysis in association with ABO incompatibility occurs very rarely. Two cases of hydrops fetalis in black infants caused by anti-B haemolysins are reported. The greater severity of ABO incompatibility in black African peoples may have important implications for antibody screening in this ethnic group.     

Hydrops fetalis associated with Ureaplasma urealyticum

A hydroptic newborn was born at 32 weeks' gestation and at the age of 14 h died of post-asphyxial syndrome. Immunologic causes of hydrops fetalis were excluded, as were anomalies and chromosomal aberrations. Ureaplasma urealyticum was isolated in bronchial secretions, lung tissue and brain tissue of the newborn. Our findings suggest that U. urealyticum infection should be considered in the differential diagnosis of hydrops fetalis.     

Hydrops fetalis due to ABO incompatibility

Hemolytic disease of the newborn due to ABO incompatibility was first observed by Halbrecht in 1944. This entity has a spectrum ranging from minimal hemolysis requiring no therapy, as is the case in most instances, to severe hemolytic disease requiring aggressive management including exchange transfusion in a small percentage of cases. An extreme degree of hemolytic disease of the newborn due to ABO incompatibility, i.e., hydrops fetalis, has not been well documented in the English literature. We present a case of hydrops fetalis due to ABO incompatibility. The severity of hemolytic disease due to ABO incompatibility can be forecast when indicated in selected cases.     

Hydrops fetalis associated with Noonan syndrome]

A case of Noonan syndrome associated with hydrops fetalis has been reported; it is recalled that morphological anomalies common to both Turner and Noonan syndromes depend on similar lymphatic anomalies. In the present case it is therefore proposed that the malformations of Noonan syndrome and hydrops fetalis proceed from the same lymphatic anomalies.     

Hydrops fetalis associated with erythrocyte pyruvate kinase deficiency

The authors report a case of hydrops fetalis due to severe pyruvate kinase deficiency, the most unusual clinical manifestation of this disease. Conclusion Pyruvate kinase deficiency, as other erythrocyte enzymopathies, must be considered in the differential diagnosis of non-immune hydrops fetalis. This has important implications for clinical investigations, therapy and genetic counselling. Received: 15 November 1998 / Accepted in revised form: 17 April 1999     

Hydrops foetalis caused by hepatic haemangioma

The authors report a moderately premature baby with Down's syndrome and hydrops, the latter probably caused by a large hepatic haemangioma which was diagnosed only after birth. At birth the baby was affected by massive right hydrothorax, ascites, hypoalbuminaemia and severe respiratory distress. With the use of modern neonatal intensive care, the baby survived. Corticosteroid treatment (prednisolone 2 mg kg⁻¹ d⁻¹ i.v. in divided doses) was associated with a very rapid resolution of the haemangioma and the baby was healthy at follow-up. Although hepatic angiomas are not uncommon in the neonatal period, the association with hydrops is a rare finding.