December 1st, 2023

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Spontaneous Resolution of Idiopathic Hydrops Fetalis A Case Report
Authors:  Madison Anzelc, B.S., B.A., Anne Ruch, M.D., FACOG, Julia Mendiola, B.S., and Melani Kekulawala, B.S., M.P.H.
BACKGROUND: Due to the utilization of routine Rho (D) immunoglobulin, the majority of causes of hydrops fetalis are now non-isoimmune (NIHF) in etiology. Overall mortality for this condition is about 50–98%. There are only two cases of spontaneous resolution of idiopathic NIHF reported in the current literature. Moreover, according to the literature, an earlier diagnosis of NIHF is associated with poorer outcomes.

CASE: This report describes a case of prenatally diagnosed hydrops with scalp edema, pericardial effusion, and ascites of unknown origin at 16 weeks of gestation. All prenatal laboratory results and screenings were unremarkable. All signs of hydrops fetalis completely resolved after 4 weeks without intervention. The infant was successfully delivered and has reached all expected milestones at 9 months of age.

CONCLUSION: This case is unique as it demonstrates a rapid 4-week complete resolution of NIHF despite a poor prognostic factor of early detection.
Keywords:  hydrops fetalis; immunoglobulins; labor, obstetrics; pregnancy; prenatal diagnosis
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