A case of Non immune hydrops fetalis incidentally found on routine obstetric sonography

Abstract

Non-immune hydrops fetalis is a severe condition that is uncommon and usually associated with a poor prognosis. It is characterized by abnormal accumulation of fluid in two or more fetal body compartments, along with generalized soft tissue edema. Before 1968, hydrops fetalis was secondary to maternal-fetal Rh incompatibility, but today most cases are non-immune origin due to the widespread use of Rhesus-D-alloimmunisation. A long list of aetiologies is found with non-immune hydrops fetalis, which varies from genetic abnormalities to cardiac conditions, infections, hematological and autoimmune causes, each with the potential to affect the fetus severely. We report a case of 24-year-old female, Gravida 2 para 1, who presented to our hospital for a regular antenatal check-up at 28 weeks of gestation for fetal well-being. Routine antenatal ultrasound findings revealed gross ascites with abdominal wall edema, mild pleural effusion, pericardial effusion, and generalized fetal edema. The first baby is alive and healthy, delivered at 39 weeks. History of previous pregnancy and previous studies exclude the causes of immune hydrops fetalis, making this case most likely suggestive of the non-immune type.