Objective
The pathophysiology of fetal hydrops is still unclear. One factor that is believed
to contribute to hydrops is hypoalbuminemia. Our research question was whether hypoalbuminemia
in immune hydrops is causative or a secondary effect.
Study design
Between 1987 and 2005, fetal blood samples were taken at the first fetal blood transfusion
in 224 Rh-D alloimmunized pregnancies. We measured hemoglobin concentration and albumin
concentration and assessed the severity of hydrops.
Results
A decrease in albumin concentration occurred only below a hemoglobin deficit of >8
SDs in 27 fetuses. In 161 nonhydropic, 44 mildly hydropic, and 19 severely hydropic
fetuses, albumin concentrations were >2 SDs below the mean for gestational age in
6%, 14%, and 63%, respectively.
Conclusion
Our finding that most fetuses with immune hydrops have an albumin concentration within
the normal range (71%) suggests that hypoalbuminemia is unlikely to cause the initial
development of immune hydrops.
Key words
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References
- Before the horse is out of the barn: fetal surgery for hydrops.Semin Perinatol. 1995; 19: 462-473
- The severity of immune fetal hydrops is predictive of fetal outcome after intrauterine treatment.Am J Obstet Gynecol. 2001; 185: 668-673
- Pathophysiology of hydrops fetalis.Semin Perinatol. 1995; 19: 437-446
- Evidence of endothelium involvement in the pathophysiology of hydrops fetalis?.Early Hum Dev. 2000; 57: 205-209
- Fetal liver dysfunction in Rh alloimmunization.BJOG. 1991; 98: 287-293
- Cardiorespiratory status of erythroblastotic newborn infants: II, blood volume, hematocrit, and serum albumin concentration in relation to hydrops fetalis.Pediatrics. 1974; 53: 13-23
- Do abnormal Starling forces cause fetal hydrops in red blood cell alloimmunization?.Am J Obstet Gynecol. 1992; 167: 907-912
- Ultrasound evaluation of tachycardia-induced hydrops in the fetal lamb.Am J Obstet Gynecol. 1987; 157: 655-659
- The effect of outflow pressure upon thoracic duct lymph flow rate in fetal sheep.Pediatr Res. 1992; 32: 585-588
- Congenital cystic adenomatoid malformation: a sheep model of fetal hydrops.J Pediatr Surg. 1994; 29: 692-696
- Atrial natriuretic factor in hydrops fetalis caused by Rh isoimmunisation.Arch Dis Child. 1990; 65: 683-686
- Prenatal treatment of fetal hydrops associated with the hypertelorism-dysphagia syndrome (Opitz-G syndrome).Prenat Diagn. 1986; 6: 109-115
- Idiopathic hydrops fetalis successfully treated in utero.Obstet Gynecol. 1988; 71: 984-986
- Fetal haemoglobin measurement in the assessment of red cell isoimmunisation.Lancet. 1988; 1: 1073-1075
- Fetal blood values by percutaneous umbilical blood sampling.Fetal Ther. 1989; 4: 152-160
- Hydrops in fetal sheep from rapid induction of anemia.Pediatr Res. 1994; 35: 560-564
- The relationship of fetal plasma protein concentration and hemoglobin level to the development of hydrops in rhesus isoimmunization.Am J Obstet Gynecol. 1985; 152: 341-344
- Reduction in plasma protein does not affect body water content in fetal sheep.Pediatr Res. 1991; 29: 623-626
- Changes in fetal and maternal plasma protein concentration and colloid osmotic pressure with gestation.J Dev Physiol. 1991; 15: 347-350
Article Info
Publication History
Accepted:
February 15,
2006
Received in revised form:
February 15,
2006
Received:
December 9,
2005
Footnotes
Presented at the 26th Annual Meeting of the Society for Maternal Fetal Medicine, January 30-February 4, 2006, Miami, FL.
Identification
Copyright
© 2006 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
