Purpose or Case Report: Overview:
Fetal Hydrops is a rare complication of pregnancy, occurring in approximately 1 in 1700 to 3000 pregnancies. Given the generally poor outcomes in neonates with fetal hydrops, including high rates of miscarriage, still birth and neonatal death, early detection in these cases can be essential in helping guide decision making during pregnancy and beyond. While ultrasound is the primary screening tool in these patients, fetal MRI provides vital information in cases of hydrops that can help guide management. Few resident radiologists are exposed to these types of MRIs, many of which often have critical findings essential to guiding patient care. In this educational exhibit we will demonstrate the imaging findings of fetal hydrops on prenatal MRI with a focus on fetal hydrops in suspected trisomy 21, noting that up to 35% of fetuses with hydrops have trisomy 21. Additionally, we will review common ultrasound findings in fetal hydrops and discuss considerations for management in these cases.

Outline:
Overview of Fetal Hydrops
Review of association of fetal hydrops and trisomy 21
Discussion of early detection and screening with Ultrasound
Prenatal MRI evaluation in a case of fetal hydrops in a patient with suspected trisomy 21, using images obtained at the University of New Mexico
Checklist of commonly affected structures and findings to improve detection and patient management
Brief discussion of potential prenatal/fetal surgical interventions in these cases

Goals:
Improve awareness and recognition of the imaging findings in fetal hydrops
Provide a potential search pattern for trainees in tackling these complex cases
Discuss the association of fetal hydrops with trisomy 21
Review the utility of imaging on planning of interventions when hydrops is identified
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