Resolution of Cystic Hygroma, Hydrops Fetalis, and Fetal Anemia

Cystic hygroma with hydrops fetalis is considered to have grave prognosis. This report describes a case of resolution of cystic hygroma, hydrops fetalis, and fetal anemia in a female fetus with a normal karyotype. Cystic hygroma and hydrops fetalis were noted on a routine ultrasound examination at 27 weeks' gestation in a fetus with 46,XX karyotype. Fetal blood sampling at 30 weeks' gestation showed fetal hemoglobin of 64 gm/liter. Intrauterine blood transfusion at 30 weeks' gestation raised the hemoglobin level to 91 gm/liter. Serial ultrasound studies demonstrated complete resolution of cystic hygroma and marked reduction of hydrops fetalis. The fetus was delivered at term. She was noted to have redundant skin of posterior neck and edema of upper and lower extremities. Hemoglobin level at birth was 151 gm/liter. Regular follow-up to 6 months of age showed the baby to have normal growth and development, with the return of the skin at the posterior neck to normal.