Imaging description

A term infant presented with generalized anasarca, pleural effusion, and acites. A radiograph of the chest and abdomen/pelvis confirmed marked, generalized soft tissue swelling and bilateral pleural effusions (Fig. 81.1). There were several focal, round calcifications projecting below the right 12th rib, at the expected location of the gallbladder. An ultrasound confirmed numerous gallstones in the gallbladder (Fig. 81.2). There was no evidence of gallbladder wall thickening, pericholecystic fluid, cholestasis, or other abnormalities of the bile ducts.

Importance

A hydrops fetalis is defined by the presence of fluid accumulation in at least two anatomic compartments in the fetus or newborn. Based on its etiology, two types of hydrops fetalis are distinguished: immune hydrops and non-immune hydrops. Gallstones are frequently noted in patients with immune-mediated hydrops, but not in patients with non-immune causes of hydrops. Hydrops fetalis is a serious condition, which can result in death of the infant shortly before or after delivery.