What is hydrops fetalis?
Hydrops fetalis is severe swelling (edema) in an unborn baby or a newborn baby. It
is a life-threatening problem. There are 2 types: immune and nonimmune.
What causes hydrops fetalis?
Hydrops develops when too much fluid leaves the bloodstream and goes into the tissues.
Many diseases and complications can cause hydrops.
This type of hydrops is not very common. It may develop because of Rh disease in the
mother. If you are Rh negative and have an Rh positive baby, your immune system attacks
your unborn baby’s red blood cells. This causes anemia. Hydrops can occur if the developing
baby's organs can't overcome the anemia. The heart starts to fail. Large amounts of
fluid build up in the baby's tissues and organs. This type of hydrops is not common
today because Rh negative women are usually treated with Rh immunoglobulin to prevent
This is the more common type of hydrops. This type includes all other diseases or
complications that may interfere with how your baby manages fluid. Some of the diseases
or conditions that can cause nonimmune hydrops include:
- Severe anemia
- Infections present before birth
- Heart or lung defects
- Chromosomal abnormalities and birth defects
- Liver disease
What are the symptoms of hydrops fetalis?
Symptoms can occur a bit differently in each child. Below are the most common symptoms
During pregnancy, symptoms may include:
- Large amounts of amniotic fluid
- Thickened placenta
- Ultrasound of the unborn baby that shows enlarged liver, spleen, or heart. It may
show a fluid buildup around the baby’s abdominal organs, heart, or lungs.
After birth, symptoms may include:
- Pale coloring
- Severe swelling overall, especially in the baby's belly (abdomen)
- Trouble breathing
- Enlarged liver and spleen
The symptoms of hydrops may look like other health conditions. It is almost always
diagnosed during pregnancy or immediately at birth. Make sure your baby sees his or
her healthcare provider for a diagnosis.
How is hydrops fetalis diagnosed?
Before birth your baby may need these tests:
- Ultrasound. This test uses sound waves to create images of blood vessels, tissues, and organs.
The healthcare provider will use the ultrasound to look at how your baby's internal
organs are working. The provider can see how blood flows through different vessels.
- Fetal blood sampling. This is done by placing a needle through your uterus and into one of your baby’s
blood vessels or the umbilical cord.
- Amniocentesis. This test involves removing some of the amniotic fluid around your baby for testing.
How is hydrops fetalis treated?
Treatment of hydrops depends on the cause. During pregnancy, hydrops may be treatable
only in certain cases. You may need to deliver your baby early. In a newborn baby,
treatment may include:
- Help for breathing problems. This may be with extra oxygen or a breathing machine
- Removing extra fluid from spaces around the lungs, heart, or inside the belly using
What are the complications of hydrops fetalis?
The severe swelling that occurs with hydrops can overwhelm the baby's organ systems.
About 50% of unborn babies with hydrops don’t survive. Risks for other problems are
also high for babies born with hydrops. Survival often depends on the cause and treatment.
Key points about hydrops fetalis
- Hydrops fetalis is severe swelling (edema) in an unborn baby or a newborn baby. It
is a life-threatening problem.
- Hydrops develops when too much fluid leaves the baby's bloodstream and goes into the
- Treatment of hydrops depends on the cause.
- About 50% of unborn babies with hydrops don’t survive.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.