There are many conditions that can cause hydrops fetalis. Some cases are idiopathic with no identifiable causes after a complete evaluation. Chronic anemia and/or congestive heart failure underly many cases.


Immune hemolysis:

(1) Rh isoimmunization

(2) ABO isoimmunization

(3) isoimmunization to another red blood cell antigen


Hematologic disorder:

(1) G6PD deficiency

(2) homozygous alpha-thalassemia


Chronic blood loss:

(1) twin-twin tranfusion

(2) chronic fetomaternal transfusion


Chromosomal disorder:

(1) XO syndrome

(2) trisomy

(3) other


Cardiovascular disorder:

(1) congenital heart disease

(2) endocardial fibroelastosis

(3) fetal arrhythmias (tachyarrhythmia, heart block, etc)

(4) large arteriovenous malformation

(5) cardiac tumors


Pulmonary disorder:

(1) cystic adenomatoid malformation

(2) pulmonary lymphangiectasis

(3) pulmonary sequestration

(4) chylothorax


Renal disorder:

(1) congenital nephrotic syndrome

(2) renal vein thrombosis

(3) lower urinary tract obstruction



(1) parvovirus B19

(2) cytomegalovirus

(3) listeriosis

(4) toxoplasmosis

(5) syphilis

(6) other infection


Liver disease:

(1) fetal hepatitis

(2) fetal hepatic necrosis

(3) metabolic storage disorders (Gaucher's etc)


Skeletal disorders:

(1) chondrodysplasia

(2) disorders associated with fetal hypomobility



(1) fetal neoplasms


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