抄録
Hydrops fetalis is a rare disease which is most commonly associated with morbus haemolyticus neonatorum due to fetalmaternal blood incompatibility of the Rh antigens.
In Japan, during 5 years from 1966 through 1970, there were 37 cases (0.46%) of hydrops fetalis reported among 7, 992 autopsy cases of the fetal and neonatal infants.
We discussed chiefly the causes of hydrops fetalis reported in two of our autopsy cases, in which one showed pathologically similar findings to those of morbus haemolyticus neonatorum without evidence of fetal-maternal blood incompatibility and another showed morbus haemolyticus neonatorum due to blood incompatibility in the Rh (C) factor.
Although the most cases of morbus haemolyticus neonatorum are a consequence of fetal maternal blood incompatibility in the Rh factor, chiefly D antigens, and the ABO factor, it has not been rare to find those, which are due to maternal antibody against C or E antigens of fetal Rh factor in Japan.
Some of the hydrops fetalis are unassociated with morbus haemolyticus neonatorum. Among them, maternal hypoalbuminemia may be one of the most important factor to occurence of hydrops. Notably the high incidence of toxemia in cases of hydrops has been generally recognized as our cases, in which their placenta has revealed microscopically marked syncytial budding and/or necrotic foci fused with fibrinous materials.
Not only major feto maternal disorders as shown Driscoll et al, but also their several abnormal conditions may have some connection with occurence of hydrops, for examples edema, hypoalbuminemia and anemia of mother and immaturity of the fetal organs found in cortical cysts of kidney and adrenal gland and enlargement of adrenal fetal zone in our cases.
We noted several cases of hydrops fetalis in the literatures associated with infantile arterial calcification, with Gaucher disease and with both of these diseases showing feto-maternal blood incompatibility.
It has been well known that hyperplasia of the pancreatic islets with hypersecretion of the insuline has occured in most cases with hemolytic disease and hydrops.
Dr. Furuta, one of the writers of this article, recently presented a case of so-called infantile arterial calcification and said the calcification of the arterial wall is not main pathological findings but same kinds of degeneration occured in the wall which seemed to have connection to polysaccharide element and the case showed also hypertrophic and hydropic islets of the pancreas.
These findings are thought to be a glucometabolic disorder due to excess insulin concentration and there must be present some connection among these diseases.
