Hydrops fetalis is a condition where there is severe swelling in two or more parts of the baby's body in the womb or a newborn, for example in the lung and heart organs. This condition includes dangerous conditions that can threaten the lives of infants.
Several countries in Southeast Asia, including Indonesia, have higher rates of fetal hydrops cases compared to countries in Europe and America. This is caused by the high frequency of cases of alpha thalassemia, a disease that affects the emergence of fetal hydrops.
Types of Fetal Hydrops According to the Causes
There are two types of fetal hydrops, namely immune and non-immune. Both have different causes. The following is the explanation:
Immune fetal hydrops
This condition occurs due to rhesus mismatch, which is when the rhesus of a pregnant mother's blood is negative and rhesus of the baby's blood in the womb is positive.
This discrepancy makes the immune system of the body of pregnant women consider the baby's blood cells as foreign objects that need to be destroyed. In severe cases, severe fluid retention can occur in the baby's body to interfere with the function of his organs. This condition is called fetal hydrops.
However, immune fetal hydrops can be prevented by early detection when pregnant women undergo antenatal care. If there is a mismatch between the mother's blood rhesus with the baby, the mother will be given Rh immunoglobulin
Nonimmune fetal hydrops
Nonimmune fetal hydrops are the most common type of fetal hydrops, accounting for around 90% of cases. This condition is caused by certain diseases that interfere with the baby's body's ability to control its body fluid levels.
Diseases that can cause fetal hydrops are blood disorders, such as severe anemia and thalassemia; birth defects, such as congenital heart disease; genetic disorders, such as Turner's syndrome; and metabolic disorders, infections, or tumors.
Signs of a Baby Suffers Fetal Hydrops
During pregnancy, fetal hydrops can be identified from too much or less amniotic fluid, the baby's movement is less active, abnormal thickening of the placenta, and enlargement of some baby's organs, such as the heart, liver, lungs, or spleen. These signs can be identified through an ultrasound examination.
Whereas in newborns, fetal hydrops can be recognized by the following signs:
- Pale skin.
- Bruises on the skin.
- Severe swelling, especially in the stomach.
- Enlarged liver and spleen.
- Difficulty breathing.
- The skin and eyes appear yellow (jaundice).
Infants with fetal hydrops have a higher risk for being born prematurely. The risk of infant death will increase if fetal hydrops occur in premature babies accompanied by several other conditions, such as congenital heart defects, birth defects, and swelling of the lungs that cause difficulty in breathing.
Handling Fetal Hydrops
Handling fetal hydrops is difficult to do as long as the baby is still in the womb. But in some cases, doctors can carry out blood transfusions to the fetus, especially those with anemia, to improve their ability to survive.
The doctor may also give antiarrhythmic drugs, if the fetus with fetal hydrops has an abnormal heart rhythm (arrhythmia).
If possible, babies with fetal hydrops will be born faster, both by stimulating labor using an induction procedure or by cesarean section.
After the baby is born, handling fetal hydrops can be done by:
- Suctioning of excess fluid from the baby's body using a needle.
- Providing diuretic drugs to remove excess fluid through urine.
- Providing oxygen or installing a breathing aid (ventilator) to help the baby breathe.
- Blood transfusion in accordance with the baby's blood type, in immune fetalis hydrops.
- Surgery to correct congenital abnormalities in infants, or to remove tumors.
Hydrops fetalis is a dangerous condition that can be fatal in babies, both still in the womb and newborns. Therefore, it is important for pregnant women to carry out routine pregnancy checks to the obstetrician as a preventative measure and early treatment of fetal hydrops.
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