Isolated bilateral pleural effusion with mediastinal compression leading to hydropic change of the fetus is unusual, and carries a high risk of perinatal death. This condition can be reversed in utero by performing ultrasound-guided shunting surgery. We describe a hydropic fetus at 30 weeks' gestation with rapid recurrence of pleural ...

We report a case of homozygous alpha-thalassaemia with hydrops fetalis presenting at 22 weeks of gestation. In utero exchange transfusion was performed with maternal blood at 23 weeks. 25 weeks and 29 weeks of gestation. The fetus was delivered at 29 weeks of gestation without significant neonatal complication. Post-transfusion haemoglobin ...

BACKGROUND/AIMS: Pregnancy in hemodialysis (HD) patients tends to be diagnosed late because of its infrequency and the lack of validity of urine pregnancy tests, and because these patients tend to have menstrual irregularities. The outcome is influenced by pregnancy-related anemia. We investigated the characteristics of pregnancy-related anemia and whether it ...

Our objective was to discuss the role of erythropoietin in fetal erythropoiesis and to review its clinical uses in perinatal medicine. All relevant articles compiled through a MEDLINE search (years 1986-1997) were reviewed. Erythropoietin is essential for fetal erythropoiesis and is produced in response to hypoxia and anemia. Cord blood ...

We report the prenatal diagnosis of a transient myeloproliferative disorder suggestive of leukaemia in a fetus with hepatosplenomegaly, hydrops and 47, XY, +21 karyotype. The initial fetal white blood cell count at 26 + 5 weeks' gestation was 190/nl with 70 per cent blast cells. Immunophenotyping of the large blasts ...

Pharmacological stimulation of fetal hemoglobin production is of considerable interest as an alternative approach to therapy for Cooley's anemia. While intravenous compounds have been effective in inducing short-term increases in fetal hemoglobin in a few patients, long-term elimination of transfusion requirement has not been reported. In patients with Cooley's anemia, ...

Our purpose was to evaluate the impact of non-invasive assessment of fetal anemia and anti-D antibody quantification on the timing and frequency of invasive procedures in pregnancies complicated by rhesus alloimmunization. Nineteen consecutive non-hydropic pregnancies referred to the fetal medicine center were assigned a prior risk category (none/mild, moderate or ...

The study was conducted to report on the use of molecular biology methods and pregnancy outcome in women sensitized to either Rhesus D (RhD) or Kell 1 (K1) antigens. Paternal RhD genotype was determined by DNA amplification of an RhD-specific sequence from single sperm cells. Paternal Kell phenotype was determined ...

To manage fetal tachyarrhythmia induced hydrops, both a correct diagnosis and adequate intrauterine therapy are fundamentally important. We present a 32-week-gestational-age hydropic fetus with supraventricular tachycardia who responded dramatically after transplacental administration of high dose digoxin (1 mg intravenously daily). The baby was born at 36 weeks' gestation followed by ...

Of all pregnant women 1.2% have platelet counts below 100 x 10(9)/l. Only a small proportion of these have immune thrombocytopenic purpura (ITP). ITP is caused by antibodies directed against one's own platelets and may affect the mother as well as the fetus. No cases with documented intrauterine fetal bleeding ...

BACKGROUND: Aplastic anemia has been described rarely in pregnancy. The etiology is uncertain, and the treatment of choice, bone marrow transplant, is contraindicated in pregnancy. Thus, the occurrence of this complication during gestation presents a management challenge. Concurrent immune-mediated thrombocytopenia further complicates an already complex situation. CASE: Our patient with ...

We present an unusual case, in which a woman presenting with markedly decreased fetal movements at 29 weeks gestation following a recent increase in fundal height was noted sonographically to have fetal hydrops consisting of scalp edema, marked hepatomegaly, ascites, and polyhydramnios. No lethal structural congenital anomaly was noted. Admission ...

OBJECTIVE: This study aims at determining a cutoff value differentiating the fetal from the adult coenzyme Q10 (CoQ10) values and comparing substantial increases in CoQ10 plasma levels in fetuses with hypoxic hypoxia and nonimmune fetal hydrops. METHODS: We have selected 61 pregnancies and determined the CoQ10 levels in fetal and ...

OBJECTIVE: To investigate cranial ultrasonographic findings in survivors of monochorionic pregnancies complicated by fetofetal transfusion syndrome. STUDY DESIGN: Case details of all monochorionic twin pregnancies complicated by fetofetal transfusion syndrome were obtained from the Centre for Fetal Care database for a 3-year period. Fetofetal transfusion syndrome was diagnosed according to ...

A woman presented during two pregnancies (at 25 and 23 weeks' gestation, respectively) because the fetuses had rapid, irregular tachycardia and hydrops. After maternal drug treatment and achievement of slower fetal heart rates, the hydrops gradually resolved. Both babies were born full term with continuing atrial fibrillation. In the first, ...

Ninety-eight samples from 80 cases of spontaneous abortions after fetal death or hydrops fetalis from 12,000 pregnant women were examined using PCR. DNA was extracted from amniotic fluid, fetal blood, ascitic fluid and fetal biopsies or placenta specimens using QIA amp kits (QIAGEN). A 270-bp length fragment located within the ...

A 27-week fetus with hydrops fetalis associated with fetal tachyarrhythmia and adenovirus infection was documented by viral polymerase chain reaction (PCR). The fetal tachyarrhythmia was converted to normal sinus rhythm by maternal pharmacological therapy with digoxin. Subsequently, resolution of the hydropic changes occurred and a viable normal-appearing preterm fetus at ...

A 33-year-old primigravida at 26 weeks gestation presented with fetal hydrops and fetal anemia following prior parvovirus B19 infection. The fetus required two intrauterine transfusions of packed red cells. At 35 weeks gestation, a cesarean section was performed for obstetric reasons. As a consequence of a prenatal bowel perforation, the ...

Because of the recent referral of an anti-Kell sensitized pregnant woman, whose fetus became severely anemic despite intensive antepartum surveillance, the prevalence and characteristics of fetal Kell isoimmunization were reviewed and analyzed. Cases with Kell and RhD alloimmunization requiring intrauterine intravascular transfusions (IUT) at the Mount Sinai Medical Center during ...

Fetal hydrops is a common symptom of fetal disease at any stage of gestation. The aetiological mechanisms leading to non-immune fetal hydrops are complex and their impact variable at different stages of gestation. In early pregnancy, primary or secondary intra-uterine cardiac failures due to major cardiovascular defects are more often ...

OBJECTIVE: To evaluate the etiology and outcome of fetal hydrops of nonimmune origin diagnosed in utero during the first half of pregnancy. METHODS: We reviewed 45 cases of nonimmune fetal hydrops presenting between 11 and 17 weeks' gestation over a 4-year period. RESULTS: The median gestational age at diagnosis of ...

beta-Thalassaemia major is a severe, transfusion-dependent anaemia that also causes infertility due to iron deposition to endocrine organs. Very few pregnancies have been reported among such patients. In this report we describe the evolution and successful outcome of pregnancy in 5 Greek women with beta-thalassaemia major. There were four full-term ...

OBJECTIVE: To investigate the predictive value of the ultrasonographically measured fetal biventricular outer dimension (BVOD) in diastole in detecting neonatal anemia in pregnancies complicated by isoimmunization. STUDY DESIGN: The records of all patients evaluated for isoimmunization in pregnancy from January 1992 to December 1994 were reviewed retrospectively. The fetal BVOD ...

OBJECTIVE: To conduct a study of maternal and fetal outcome in pregnant women with transfusion-dependent beta-thalassemia major. STUDY DESIGN: The course and outcome of pregnancy were studied prospectively in 32 pregnant women with transfusion-dependent beta-thalassemia major, of which 10 were HIV 1 positive, at Sanjay Gandhi Hospital, Manipur, India, from ...

Gestational thrombocytopenia (GT) is commonly observed in pregnancies with otherwise limited obstetric and hematologic complications. However, few data are available on the natural history of the disease, and on the recurrence of thrombocytopenia in subsequent pregnancies. From June 1987 to December 1993, 37 consecutive patients with GT were enrolled in ...

We describe a case of congenital dyserythropoietic anaemia (CDA) presenting at week 20 of pregnancy with hydrops fetalis and very severe anaemia. Fetal blood examination showed marked erythroblastosis with morphologic alterations while the basic haematological and biochemical tests were in the normal range. The fetus received intravascular red blood cells ...

We report a case of spontaneous reversal in utero of hydrops fetalis caused by parvovirus B19 maternal-fetal infection. The route leading to fetal hydrops is not fully understood. Severe anemia with hypoxemia and viral fetal myocarditis have been incriminated. Then the main issue is fetal death or spontaneous abortion. Cases ...

Homozygous alpha-thalassaemia-1 is the commonest cause of hydrops fetalis in South-East Asia. Ultrasonographic features of hydrops fetalis were said to be evident only after 20 weeks of gestation. We studied 111 pregnancies at risk of homozygous alpha-thalassaemia-1 at 12-14 gestational weeks and 101 pregnancies at 17-18 weeks by abdominal ultrasound ...

Feto-maternal transfusion was studied in 2,000 pregnant Thai women. The technic used in the study was modified acid election test. The population were divided into five group, first trimester, second trimester, third, during delivery and non pregnant women. Over all fetomaternal transfusion occurred in 1,055 women (65.94%). In first trimester, ...

Homozygosity for the South-Asian alpha-thalassemia (--SEA/) deletion is a serious hematological condition that results, in most cases, in intrauterine or postnatal death due to anemia and severe hypoxia of prenatal onset. A relationship between congenital abnormalities and intra-uterine hypoxia has been postulated. However, since homozygosity for the (--SEA/) deletion is ...

OBJECTIVE: To evaluate the change in fetal serum bilirubin levels in response to intrauterine transfusion for red cell alloimmunization. METHODS: The records of 37 patients who underwent more than one intrauterine transfusion were reviewed. The following indices were extracted: pre- and post-transfusion fetal hematocrit, total and direct serum bilirubin, reticulocyte ...

Three cases of placental chorioangiomas, from 6.5 to 10 cm in diameter, were diagnosed prenatally by ultrasound and color Doppler imaging at 21-34 weeks of gestation. In 1 case, due to fetal hydrops and maternal 'mirror syndrome', immediate delivery of a neonate, who was severely anemic, thrombocytopenic and had consumption ...

Fetomaternal haemorrhage can occur spontaneously, or after abdominal trauma. We describe a case of fetomaternal haemorrhage diagnosed at 27 weeks gestation after blunt trauma. The Kleihauer-Betke smear on admission and during the first week was positive, ranging between 3% and 5%. Cordocentesis revealed a fetal haemoglobin of 8.8 gm/dl. An ...

Intrauterine fetal transfusion is currently the therapy of choice in cases of severe anti-D isoimmunisation. However, its efficacy is reduced in patients with early severe hydrops fetalis due to the technical difficulties in performing this procedure before 20 weeks' gestation. The purpose of this study was to determine whether early ...

The subject of this study was 38 cases of non-immune hydrops fetalis and 11 cases of fetal hydrothorax and/ or ascites (FH/A), a syndrome characterized by the accumulation of pleural effusion and/or ascitic fluid, without generalized skin edema, due to various etiologies, admitted to the obstetrics ward of Hokkaido University ...

We present a case of intrauterine parvovirus B19 infection, diagnosed by detection of B19 DNA in the amniotic fluid obtained at 15 weeks of gestation for chromosome analysis in an asymptomatic pregnancy, causing hydrops fetalis 7 weeks later. Following intrauterine transfusion, rapid resolution of hydrops could be observed and a ...

A 25-year-old lady presented with a severe normocytic anemia (Hb 5.3 g/dl) and a sideroblastic marrow at the end of her first pregnancy. Six months into the puerperium, after the transfusion of a total of 8 units of red cells, there was apparent spontaneous improvement and then she was lost ...

OBJECTIVE: To review the specificity and sensitivity of diagnostic techniques using the polymerase chain reaction (PCR) on amniotic fluid (AF) samples for the determination of fetal RhD status. DATA SOURCES: A MEDLINE computerized search was conducted for January 1991 through March 1996 using the key terms "polymerase chain reaction," "rhesus," ...

Maternal high dose intravenous immunoglobulin (IVIG) has shown promise in the management of severe Rh-immunization. Intravenous immunoglobulin, blocks Fe mediated antibody transport across the placenta and blocks destruction of fetal red cells and reduces maternal antibody levels. We have tried this new therapy in 6 patients with severe Rh-immunization, with ...

We report two patients where the finding of isolated fetal hydrocephalus led to the detection of severe fetal thrombocytopenia, using fetal blood sampling. Serological investigation led to the diagnosis of fetomaternal alloimmune thrombocytopenia (FMAIT) due to anti-HPA-1a. Both women had had previous unsuccessful pregnancies probably due to FMAIT; one had ...

Maternally administered digoxin for the treatment of fetal supraventricular tachycardia (SVT) complicated by hydrops fetalis may be ineffective secondary to poor transplacental drug transfer. We present our experience with eight pregnancies treated with transplacental therapy or combined maternal and direct fetal intramuscular therapy. Response to treatment following maternal intravenous administration ...

We report a pregnancy complicated by anti-B isoimmunization that resulted in fetal ascites, anemia, hepatomegaly, and polyhydramnios. A previous pregnancy in the same patient was complicated by neonatal ABO incompatibility. A review of the obstetric literature suggests that ABO incompatibility may cause severe fetal anemia, especially in patients with type ...

OBJECTIVE: Little information exists regarding thrombotic thrombocytopenic purpura and hemolytic uremic syndrome during pregnancy. We report a series of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome complicating pregnancy, with emphasis on diagnosis and management of this rare disorder. STUDY DESIGN: Between January 1988 and February 1996, 11 women with either ...

During a period of 8 years (1985-92), 100 fetuses were diagnosed to have non-immune hydrops on the basis of ultrasonographic findings and absence of rhesus isoimmunization. Both the mother and the fetus were thoroughly evaluated by a set protocol that included a detailed fetal abnormality scan with echocardiography and fetal ...

OBJECTIVE: To assess the value of the fetal nonstress test (NST) in predicting neonatal transfusion in pregnancies complicated by red cell isoimmunization. METHODS: We retrospectively reviewed the records of all patients evaluated for isoimmunization in pregnancy for the period January 1992 to December 1994. In addition to prenatal care, serial ...

Indomethacin is a very effective tocolytic agent. However, concern about its possible constrictive effect on fetal ductus arteriosus has limited the use of this medication in pregnancy. A 29-year-old woman was treated with indomethacin at 27 weeks of gestation for preterm labor and polyhydramnios. She received a dose of 75 ...

A large chorioangioma located at the insertion area of the umbilical cord was diagnosed at 19 weeks of gestation by ultrasound and color Doppler ultrasound. This chorioangioma led to a progressively appearing hydrops fetalis and to fetal distress. The infant presented at birth with edemas and ascites associated with severe ...

OBJECTIVE: To present an up-to-date review of the literature encompassing all important aspects of fetal transfusion for red blood cell alloimmunization in pregnancy. DATA SOURCES: A MEDLINE computer data base search was conducted for pertinent articles through August 1995. Additional publications were identified by cross-referencing. METHODS OF STUDY SELECTION: All ...

Fetal tachyarrhythmias are life-threatening conditions for the fetus. Long-standing tachyarrhythmias often lead to fetal cardiac failure, hydrops and death. Normalization of the fetal cardiac rhythm leads to resolution of fetal hydrops. This report describes the sequence and timing of fetal hydrops resolution after successful therapy. Fetuses with a persistent heart ...

OBJECTIVES: This study had three objectives: 1) to determine the electrophysiologic mechanisms of fetal supraventricular tachycardia at presentation and postnatally; 2) to identify the clinical and electrophysiologic predictors of hydrops fetalis; and 3) to describe the medium-term follow-up (1 to 7 years) of patients with fetal supraventricular tachycardia. BACKGROUND: Fetal ...