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Beating the odds: A case report on the successful management of a non-immune hydrops fetalis due to hemoglobin Bart’s disease

Maria Jane Ellise S. Javier, MD; Maria Rosario C. Cheng, MD, FPOGS and Marinella Agnes G. Abat, MD, FPOGS
Department of Obstetrics and Gynecology, The Medical City

Hemoglobin Bart’s hydrops fetalis, characterized by a deletion of all four ?-globin genes is the most severe and lethal form of Thalassemia disease. Mortality rate usually ranges from 60-100% of cases.1-5 Given the poor overall prognosis, most countries resort to pregnancy termination or expectant management as the only options to offer affected pregnancies.5 This paper presents a case of the successful management of a primigravid, diagnosed with hydrops fetalis at 29 4/7 weeks age of gestation. She delivered successfully to a live, preterm, baby boy who was later found out to have hydrops fetalis due to Hemoglobin Bart’s disease, and currently, continues to thrive past eight months of age. This report aims to improve the clinicians’ knowledge regarding the work up and management of pregnant patients diagnosed with hydrops fetalis, and increase the clinician’s awareness on the epidemiology, importance of targeted screening, and diagnosis of Alpha-Thalassemia in Filipino patients