OB-GYN-L Messages for October, 2004: Re: hydrops fetalis

Re: hydrops fetalis

From:

Terrence.Jones@kp.org

Tue Oct 26 15:19:38 2004

Sounds like germ line mosaicism pattern, as strict autosomal recessive would be unlikely to yield three consecutive affected. Would enlist genetics prior to induction for suggestions on tissue specimen for eval of potential inborn metabolic disorder (storage/glycosylation)/dyserythropoiesis. If reliable and motivated Pathologist - then include eval of placenta with autopsy. Was there fetal hepatosplenomegaly (increased AC) on 26 week scan? Both She and Husband have nml MCV? She hasn't a history of RAI ablation for grave's? You've mentioned the fetal echo was normal - this means exclusion of brady or tachyarrythmia (-- Ro or La antibodies?)/ ventricular arrythmia (cardiac sodium channel defect - long QT syndrome)? Any vascular anomaly noted in prior affected sibs (lymphangectasia)? tj

obaessa@hotmail.com (omaima) Sent by: ob-gyn-l@obgyn.net 10/24/2004 02:26 PM Please respond to ob-gyn-l

To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> cc: Subject: hydrops fetalis

Dear friends,this is Dr.Omaima,i came a cross this pateint which has a fetous with hydrops fetalis for the third time i would like to know if their is any suggestion regarding her manegment in this pregnancy or in her future pregnancy,she is 28 years gravida 5para 4 one normal femal child presented at 26 weeks ,ultrasound showed a fetous with hydrops(fetal ascitic,scalp oedema, plural effusion but no pericardial effusion )she had 2 previous pregnancy with hydrops fetalis ended by IUFD ,now she is 34 weeks IUFD, she had the folowing invistigation: CBC:hg 10,normal electrophoresis(for husband as well) blood group is A+ with no atypical Ab detected -ve ANA,antiphospholipid Ab(include lupus anticoagulant and crdiolpin Ab),Barvo virous B19 -ve normal TOURCH chromosomal analysis was normal(wife and husband) amniocentesis: normal femal fetous since we don't have excperts in cordocentesis it was not done echocrdiogram for the fetous was normal. my diagnosis is non immun hydrops fetalis I,m looknig for any further investigation can be done,and what is your suggestion for future pregnancy Thank you in advance for the help

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Sounds like germ line mosaicism pattern, as strict autosomal recessive would be unlikely to yield three consecutive affected. Would enlist genetics prior to induction for suggestions on tissue specimen for eval of potential inborn metabolic disorder (storage/glycosylation)/dyserythropoiesis. If reliable and motivated Pathologist - then include eval of placenta with autopsy. Was there fetal hepatosplenomegaly (increased AC) on 26 week scan? Both She and Husband have nml MCV? She hasn't a history of RAI ablation for grave's? You've mentioned the fetal echo was normal - this means exclusion of brady or tachyarrythmia (-- Ro or La antibodies?)/ ventricular arrythmia (cardiac sodium channel defect - long QT syndrome)? Any vascular anomaly noted in prior affected sibs (lymphangectasia)? tj   <table width0%> <tr valign=top> <td> <td>obaessa@hotmail.com (omaima) Sent by: ob-gyn-l@obgyn.net 10/24/2004 02:26 PM Please respond to ob-gyn-l <td>                To:        Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>         cc:                 Subject:        hydrops fetalis</table> Dear friends,this is Dr.Omaima,i came a cross this pateint which has a fetous with hydrops fetalis for the third time i would like to know if their is any suggestion regarding her manegment in this pregnancy or in her future pregnancy,she is 28 years gravida 5para 4 one normal femal child presented at 26 weeks ,ultrasound showed a fetous with hydrops(fetal ascitic,scalp oedema, plural effusion but no pericardial effusion )she had 2 previous pregnancy with hydrops fetalis ended by IUFD ,now she is 34 weeks IUFD, she had the folowing invistigation: CBC:hg 10,normal electrophoresis(for husband as well) blood group is A+ with no atypical Ab detected -ve ANA,antiphospholipid Ab(include lupus anticoagulant and crdiolpin Ab),Barvo virous B19 -ve normal TOURCH chromosomal analysis was normal(wife and husband) amniocentesis: normal femal fetous since we don't have excperts in cordocentesis it was not done echocrdiogram for the fetous was normal. my diagnosis is non immun hydrops fetalis I,m looknig for any further investigation can be done,and what is your suggestion for future pregnancy Thank you in advance for the help

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