A Case of Resolving Non-Immune Hydrops

A 36 year mother presented in her second pregnancy at 12 weeks of gestation. Her previous delivery was uncomplicated and baby weighed 3.3kg. She was immune to Rubella. A booking ultrasound scan confirmed a single fetus correct dates with a nuchal translucency of 2.4 mm. The anomaly scan at a POA of 23 weeks revealed fetal ascites, pleural effusion and pericardial effusion. There were no fetal structural abnormality. Hydrops progressed with evidence of skin oedema at 28 weeks. Fetal anaemia was suspected as there was increased peak systolic velocity in the middle cerebral vessels. A cordoscentesis was performed at a POA of 28 weeks. The fluid bilirubin, insulin levels and cytology was normal (46 XX karyotype). It showed Hb of 12.8 g/dl which was slightly below the normal. The platelet count was normal. At 33 week scan showed resolution of the edema and hydrops. Her fetal middle cerebral Doppler showed normal velocities. Her pregnancy was continued up to 38 weeks and the 3.8 Kg weight baby was delivered by an elective caesarean section. The recovery was uneventful.