Fetal hydrops: A systematic approach for the pathologist

Sarah K. Hartman, Josefine Heim-Hall

Research output: Contribution to journalReview articlepeer-review


Hydrops fetalis is identified clinically by antenatal ultrasound or upon delivery. It comes to the surgical pathologist's attention through receipt of an abnormal placenta or through request for perinatal autopsy. Abnormal fluid accumulation within multiple fetal body sites defines hydrops fetalis. Unfortunately, this clinical finding is common to a large variety and number of etiologies, and in approximately 14% to 32% of cases of fetal loss, no specific cause is identified. Etiologies may overlap among different categories but are addressed here as immune hemolysis, structural abnormalities, chromosomal/syndromes, nonimmune anemias, infection, and neoplasia. Here, we review both the pathophysiology of immune and nonimmune hydrops fetalis and suggest a systematic approach to fetal and placental autopsy to mitigate the difficulty of a comprehensive workup and identify a cause of fetal instability or loss.

Original languageEnglish (US)
Pages (from-to)179-185
Number of pages7
JournalPathology Case Reviews
Issue number5
StatePublished - Sep 2011


  • Fetal hydrops
  • NIHF
  • alloimmunization
  • nonimmune hydrops fetalis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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