Title Neimuni fetalni hidrops
Title (english) Nonimmune hydrops fetalis
Author Kristina Vuković
Mentor Dorotea Ninković (mentor)
Committee member Boris Filipović-Grčić (predsjednik povjerenstva)
Committee member Marija Jelušić (član povjerenstva)
Committee member Dorotea Ninković (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Pediatrics) Zagreb
Defense date and country 2021-07-16, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Abstract Neimuni fetalni hidrops predstavlja ozbiljno životno ugrožavajuće stanje fetusa koje nastaje zbog neadekvatne izmjene tekućina između vaskularnog i intersticijskog prostora. Shodno tome dolazi do izljeva u tjelesne šupljine poput pleuralne, perikardijalne i peritonealne te do nakupljanja tekućine u mekom tkivu fetusa koje dovodi do generaliziranog edema. Edem posteljice i polihidramnij može biti prateći nalaz. Etiologija neimunog fetalnog hidropsa je vrlo raznovrsna. Najčešće je uzrokovan kardiovaskularnim abnormalnostima, kromosomopatijama, kongenitalnim infekcijama, hematološkim bolestima, fetalnim malformacijama toraksa, gastrointestinalnog i urinarnog trakta, metaboličkim bolestima i sindromom blizanačke transfuzije. Unatoč brojnim poznatim uzrocima, nerijetko neimuni fetalni hidrops ostaje idiopatski. Također, valja naglasiti kako postoji i imuni oblik fetalnog hidropsa koji najčešće nastaje kao posljedica nekompatibilnosti Rhesus faktora između majke i fetusa, a koja rezultira aloimunizacijom i fetalnom hemolitičkom anemijom. Ovaj oblik je u prošlosti bio puno češći, no danas neimuni čini oko 90% svih slučajeva hidropsa. Dijagnoza hidropsa se uglavnom postavlja tijekom ultrazvučnog pregleda, pri kojem se jasno vide nakupine tekućine u fetusa. Od velike koristi su i dodatne popratne dijagnostičke metode poput dopplera srednje cerebralne arterije ili amniocenteze. Tijekom dijagnostičke obrade je od iznimne važnosti pokušati identificirati uzok hidropsa kako bi na vrijeme bili prepoznati entiteti koji imaju potencijalno uspješni terapijski pristup. Liječenje neimunog fetalnog hidropsa je moguće kod pojedinih etiologija, a obuhvaća antiaritmike u slučaju fetalnih aritmija, intrauterine transfuzije kod liječenja anemija, dreniranje izljeva, prvenstveno pleuralnih te lasersku ablaciju placentarnih anastomoza kod blizanačkog transfuzijskog sindroma.
Abstract (english) Nonimmune hydrops fetalis is a serious life-threatening condition of the fetus that occurs due to inadequate fluid exchange between the vascular and interstitial space. Consequently, there are effusions into body cavities such as pleural, pericardial and peritoneal, and an accumulation of fluid in the soft tissue of the fetus leading to generalized edema. Placental edema and polyhydramnios may be an accompanying finding. The etiology of nonimmune hydrops fetalis is diverse. It can be caused by cardiovascular abnormalities, chromosomopathies, congenital infections, hematological diseases, fetal malformations of the thorax, gastrointestinal and urinary tract, metabolic diseases and twin to twin transfusion syndrome. Despite the number of known causes, often nonimmune hydrops fetalis remains idiopathic. It should also be noted that there is an immune form of fetal hydrops that most often results from Rhesus incompatibility between mother and fetus, resulting in alloimmunization and fetal hemolytic anemia. This form was much more common in the past, but today nonimmune accounts for about 90% of all hydrops cases. The diagnosis of hydrops is usually made during an ultrasound examination, in which fluid accumulations in the fetus are clearly seen. Concomitant diagnostic methods such as middle cerebral artery Doppler or amniocentesis also can be performed. During diagnostic processing, it is extremely important to try to identify the cause of hydrops in order to recognize entities that have a potential therapeutic approach in time.
Treatment of nonimmune hydrops fetalis is possible in some cases. It includes antiarrhythmics in the case of fetal arrhythmias, intrauterine transfusions in the treatment of anemia, drainage of effusions, primarily pleural and laser ablation of placental anastomoses in twin to twin transfusion syndrome.
Keywords
neimuni fetalni hidrops
izljevi
edemi
Keywords (english)
nonimmune hydrops fetalis
effusions
edema
Language croatian
URN:NBN urn:nbn:hr:105:215464
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Repository Dr Med - University of Zagreb School of Medicine Digital Repository
Created on 2022-05-20 08:55:34