Pediatric Hydrops Fetalis Clinical Presentation

Updated: Jul 25, 2017
  • Author: Ashraf H Hamdan, MD, MBBCh, MSc, MRCP, FAAP; Chief Editor: Dharmendra J Nimavat, MD, FAAP  more...
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Presentation

History

A history suggesting the presence of any of the factors listed below should trigger an extensive diagnostic study for hydrops fetalis.

Maternal history

The following maternal factors warrant an investigation for hydrops fetalis:

  • Rh negative (d;d) blood type
  • Known presence of isoimmune blood group antibodies
  • Prior administration of blood products
  • Risks of illicit drug use
  • Collagen vascular disease
  • Thyroid disease or diabetes
  • Organ transplant (liver, kidney)
  • Blunt abdominal trauma (abuse, auto accident)
  • Coagulopathy
  • Use of indomethacin, sodium diclofenac, or potentially teratogenic drugs during pregnancy
  • Younger (<16 years) or older (>35 years) maternal age
  • Risk factors for sexually transmitted diseases
  • Hemoglobinopathy (especially with Asian or Mediterranean ethnicity)
  • Occupational exposure to infants or young children
  • Pet cat
  • Current or recent community epidemic of viral illness

Family history

The following family history factors warrant an investigation for hydrops fetalis:

  • Prolonged or excessive jaundice in siblings as newborns
  • Presence of jaundice in other family members
  • Family history of twinning (specifically, monozygotic)
  • Family history of genetic disorders, chromosomal abnormalities, or metabolic diseases
  • Congenital malformation in previous child
  • Previous fetal death
  • Polyhydramnios or oligohydramnios in earlier pregnancies
  • Prior hydrops fetalis
  • Previous fetomaternal transfusion
  • Congenital heart disease in previous child
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Physical Examination

The presence of any of the following maternal or fetal physical examination findings should prompt further diagnostic evaluation:

  • Twinning
  • Polyhydramnios or oligohydramnios
  • Exanthem or other evidence of intercurrent viral illness
  • Herpetic lesion or chancre
  • Decrease in fetal movements
  • Fetal tachyarrythmias
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