Pathophysiology of hydrops fetalis

• Published in: Seminars in perinatology Vol. 19; no. 6; pp. 437 - 446
• Main Author: Apkon, Michael
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.1995
• Subjects: Capillary Permeability - physiology; Extracellular Space - physiology; Humans; Hydrops Fetalis - etiology; Hydrops Fetalis - physiopathology; Lymphatic System - physiology; Microcirculation - physiology; Nutritional Physiological Phenomena; Oxygen - pharmacokinetics; Ultrafiltration
• ISSN: 0146-0005; 1558-075X
• DOI: 10.1016/S0146-0005(05)80051-5

Hydrops fetalis occurs when the rate of interstitial fluid production by capillary ultrafiltration exceeds the rate of interstitial fluid return to the circulation via lymphatic vessels. Developmental differences in the microcirculation and lymphatic system of the fetus, as compared with mature subjects, renders the fetus susceptible to interstitial fluid accumulation. These differences include greater capillary permeability, more compliant interstitial compartment, and greater influence of venous pressures on lymphatic return. The balance between interstitial fluid production and removal is most commonly disrupted as a consequence of homeostatic mechanisms serving to preserve adequate systemic delivery of metabolic substrate when cardiocirculatory function is impaired. The pathophysiology of two conditions of impaired cardiocirculatory function, atrial tachycardia and severe anemia, serve as examples of the mechanisms by which these homeostatic mechanisms perturb the balance of interstitial fluid movement.