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The surprising truth about Rh disease: Why does it cause hydrops fetalis?
Hydrops fetalis, or hydrops fetalis, is a condition that develops in the fetus and is characterized by fluid accumulation or swelling in at least two fetal cavities. This condition can have serious effects on fetal growth and development, but its causes and mechanisms are often puzzling.
There are many manifestations of edema, which can affect the fetal forehead skin, chest (pleural effusion), pericardium (pericardial effusion) and abdomen (ascites). These symptoms are caused by early heart failure due to the fetal heart's inability to keep up with demand, usually abnormally high blood flow.
Eedema is usually a manifestation of the fetal subcutaneous tissue and may even lead to spontaneous abortion in some cases.
Pathophysiology of edema
Hedes fetalis usually results from fetal anemia. In this case, the fetal heart needs to increase blood delivery to provide sufficient oxygen. This anemia may be due to immune or non-immune causes.
Immunopathophysiology
Rh disease (Erythroblastosis fetalis) is the only immune factor causing edema. When there are differences in Rh antigens between the pregnant mother and the fetus (for example, the mother is Rh-negative and the fetus is Rh-positive), the mother's immune system will produce antibodies against the fetus' red blood cells, causing the dissolution of the red blood cells and ultimately causing severe anemia.
The impact of Rh disease is due to the mother's attack on the fetal Rh-positive red blood cells, causing the decomposition of fetal red blood cells, resulting in hemolytic anemia.
Non-immune pathophysiology
The causes of non-immune edema are diverse and may include fetal tumors, heart defects, twin-graft syndrome, etc. All of these factors can increase cardiac output demands, leading to heart failure and corresponding edema.
Many diseases and conditions can cause edema, including: anemia, arrhythmia, fetal infection, etc.
Diagnostic methods
The diagnosis of hydrops fetalis mainly relies on ultrasound examination. The diagnosis is confirmed under ultrasound if excess serum fluid is found in at least one cavity, accompanied by skin edema (more than 5 mm thick).
Treatment Plan
Treatment of edema depends on its cause and the stage of pregnancy. For fetuses with severe anemia, in utero blood transfusions may be needed to increase the fetus's survival before delivery. For heart problems, such as arrhythmia, the condition may be improved through the mother's medication.
In some cases, hydrops fetalis can be treated with medical intervention, such as drainage of intrauterine fluid, to reduce pressure on the fetus.
Although many treatment options are now available, there are many factors to consider, including the specific condition of the fetus, the mother's health, and how many weeks into the pregnancy it is. In addition, modern medicine is also committed to the prevention of such conditions, thereby reducing the incidence of Rh disease and related edema.
As medical technology advances, however, the question remains: What can we do to identify in advance and effectively manage these conditions when they occur again?
