Immune Fetal Hydrops (Ascites)

---

Figure-1

📄 Report Sample Line - Immune Fetal Hydrops (Ascites)

Evidence of fetal ascites with free fluid noted in the peritoneal cavity. Additional features of hydrops include scalp edema and bilateral pleural effusions. The fetal skin appears edematous, and the umbilical vein is dilated. Mild cardiomegaly is also observed. No structural cardiac or other anatomic abnormalities are identified. Amniotic fluid volume is increased (polyhydramnios), and the placenta appears thickened. Middle cerebral artery peak systolic velocity (MCA-PSV) is elevated, suggestive of fetal anemia.

These findings are consistent with **Immune Fetal Hydrops**, likely secondary to red cell alloimmunization (e.g., Rh isoimmunization).

Conclusion: 📋 Ultrasound findings are consistent with Immune Hydrops Fetalis, with fetal ascites, edema, pleural effusion, and Doppler features suggestive of fetal anemia.

Recommendation: Recommend urgent referral to a fetal medicine unit. Monitor MCA-PSV trends closely. Consider intrauterine transfusion if fetal anemia is confirmed. Serial follow-up and multidisciplinary perinatal management are essential. Maternal antibody titers and prior transfusion history should be reviewed in detail.

---

Note: If you select English, answer all questions in English.
यदि आप हिंदी चुनते हैं, तो सभी प्रश्न हिंदी में हल करें।

1. Immune fetal hydrops (ascites) is most commonly caused by: 1. इम्यून भ्रूणीय हाइड्रोप्स (अस्काइट्स) का सबसे आम कारण क्या है?
A. Maternal alloimmunization (eg, Rh‑D incompatibility causing fetal hemolytic anemia)
B. Maternal smoking only
C. Fetal lung malformation only
D. Placental abruption only

2. Ultrasound hallmark of fetal hydrops includes: 2. भ्रूणीय हाइड्रोप्स का अल्ट्रासाउंड मुख्य लक्षण क्या है?
A. Single small effusion only
B. Accumulation of fluid in two or more fetal compartments (eg, ascites + pleural effusion, or skin edema + ascites)
C. Only placental calcifications
D. Only increased fetal movements

3. The single best Doppler test to screen for fetal anemia in immune hydrops is: 3. इम्यून हाइड्रोप्स में भ्रूणीय एनीमिया के लिए स्क्रीनिंग करने के लिए सर्वश्रेष्ठ एकल डॉप्लर परीक्षण क्या है?
A. Umbilical artery pulsatility index
B. Middle cerebral artery peak systolic velocity (MCA‑PSV)
C. Maternal carotid Doppler
D. Ductus venosus waveforms only

4. Important maternal tests when immune hydrops is suspected include: 4. इम्यून हाइड्रोप्स संदेह होने पर महत्वपूर्ण मातृ परीक्षण में क्या शामिल है?
A. Maternal antibody screen (indirect Coombs), blood group/Rh and Kleihauer–Betke or fetal‑maternal hemorrhage testing
B. Maternal urine culture only
C. Maternal bone density scan
D. No maternal tests are needed

5. First‑line fetal therapy for severe anemia causing hydrops is: 5. हाइड्रोप्स का कारण बनने वाली गंभीर एनीमिया के लिए प्रथम पंक्ति भ्रूणीय चिकित्सा क्या है?
A. Intrauterine fetal transfusion (IUT) into the umbilical vein
B. Maternal antiviral therapy only
C. Immediate cesarean at any gestation
D. No treatment available

6. Sonographic feature that suggests fetal ascites is: 6. भ्रूणीय अस्काइट्स का संकेत देने वाला सोनोग्राफिक लक्षण क्या है?
A. Anechoic fluid in the fetal abdomen with bowel displacement
B. Echogenic solid mass only
C. Increased femur length only
D. Absence of stomach bubble

7. Prophylaxis to prevent immune hydrops in an Rh‑negative mother is: 7. आरएच‑नकारात्मक मां में इम्यून हाइड्रोप्स को रोकने के लिए प्रतिरक्षण क्या है?
A. Anti‑D immunoglobulin (Rho(D) immune globulin) at appropriate times
B. Maternal iron tablets only
C. High‑dose vitamin C
D. No prophylaxis exists

8. Which ultrasound sign indicates advanced hydrops with poor prognosis? 8. कौन‑सा अल्ट्रासाउंड संकेत उन्नत हाइड्रोप्स और खराब पूर्वानुमान का संकेत देता है?
A. Isolated small pleural effusion only
B. Generalized skin edema, massive ascites and pleural/pericardial effusions with cardiomegaly
C. Normal amniotic fluid index
D. Increased fetal movements only

9. After successful IUT, which parameter is used to monitor response? 9. सफल IUT के बाद प्रतिक्रिया की निगरानी के लिए कौन‑सा पैरामीटर उपयोग किया जाता है?
A. Serial MCA‑PSV returning towards normal values and reduction of hydrops features
B. Only maternal blood pressure
C. Fetal femur length only
D. No monitoring is required

10. Key counseling point for parents about immune fetal hydrops (ascites) is: 10. इम्यून भ्रूणीय हाइड्रोप्स (अस्काइट्स) के बारे में माता‑पिता को दिया जाने वाला प्रमुख परामर्श क्या है?
A. Prognosis depends on severity, gestational age, and response to interventions (IUT); multidisciplinary care and possible neonatal support required
B. It always resolves without treatment
C. No follow‑up is ever needed
D. Only maternal bed rest will cure it