Approach to the diagnostic evaluation of nonimmune hydrops fetalis in fetuses with a normal fetal structural survey and normal sinus rhythm

CMV: cytomegalovirus; CVS: chorionic villus sampling; MCA-PSV: middle cerebral artery peak systolic velocity; MFM: maternal-fetal medicine; PCR: polymerase chain reaction.

* Refer to UpToDate content on fetomaternal hemorrhage.

¶ Refer to UpToDate content on screening for hemoglobinopathies in the reproductive setting.

Δ Refer to UpToDate content parvovirus B19, cytomegalovirus, and toxoplasmosis in pregnancy.

◊ If fetal diagnostic testing declined, consider parental evaluation such as carrier screening and postnatal consultation with a genetics expert.

§ Refer to UpToDate content on syphilis in pregnancy. Diagnostic testing of amniotic fluid or fetal blood definitively establishes fetal infection, but results of invasive procedures to obtain fetal specimens do not change management and thus such testing is not recommended.