Intrauterine treatment of idiopathic hydrops fetalis.

Seven fetuses with idiopathic hydrops fetalis (IHF) were treated in utero by injecting albumin into the fetal abdominal cavity and by removal of accumulated fluid from the serous cavities. Signs of hydrops fetalis disappeared in utero in one, and skin edema significantly decreased in another. In the other five, signs of hydrops fetalis remained unchanged in utero. The hourly fetal urine production rate (HFUPR) increased after albumin injection in three of five. The interval between the initial diagnosis and delivery ranged from 3 to 14 weeks. Gestational age at the time of delivery ranged from 33 to 40 weeks. There were no stillbirths. Two of three without pleural effusion survived, but four with pleural effusion died of respiratory failure during the neonatal period due to pulmonary hypoplasia. These results indicate that albumin injection into the fetal abdomen in utero deserves further attention and that other therapeutic methods should be established to enhance the development of the lungs in cases of intrauterine treatment of IHF with pleural effusion.