Nonimmune hydrops fetalis, characterized by the accumulation of interstitial water (anasarca) in the absence of isoimmunization, has been associated with at least 38 different pathologic entities, accounting in 1970 for approximately 20% of reported hydropic infants.1-3 Surprisingly, the association of hydrops and congenital heart disease is an uncommon observation,1 but has been reported sporadically in patients with premature closure of either the patent foramen ovale or ductus arteriosus, Ebstein's anomaly of the tricuspid valve, severe pulmonary insufficiency, both right and left ventricular endocardial fibroelastosis, myocarditis, cerebral, pulmonary, and abdominal arteriovenous fistulae, hypoplastic left heart syndrome, and cardiac arrhythmias.1 Interestingly, intrapericardial teratomas have been associated with pericardial effusion,4-8 usually with cardiac tamponade in infants,4,5,8 but not with hydrops. This report presents the clinical features of a newborn with an intrapericardial teratoma and hydrops fetalis, and discusses the incidence, diagnosis, and management.
Report of a Case.—The