Hydrops Fetalis Precision Panel
Hydrops fetalis or fetal hydrops is a lethal fetal condition defined as abnormal accumulation of fluid in two or more fetal compartments presenting as ascites, pleural effusion, pericardial effusion and skin edema.

Hydrops fetalis or fetal hydrops is a lethal fetal condition defined as abnormal accumulation of fluid in two or more fetal compartments presenting as ascites, pleural effusion, pericardial effusion and skin edema. It may also be associated with polyhydramnios and placental edema. Hydrops is usually detected using ultrasound in the first or second trimester of pregnancy. The etiology can be immune or nonimmune. Immune hydrops fetalis is due to Rhesus (Rh) or ABO incompatibility and other blood group antibodies causing hemolytic disease of the newborn. Nonimmune hydrops fetalis can be divided as fetal, maternal, placental and idiopathic. A wide spectrum of genetic causes may lead to nonimmune hydrops fetalis (NIHF), and so a phenotypic and genetic evaluation are necessary to determine the underlying etiology. The mode of inheritance is generally autosomal recessive and autosomal dominant, although several X-linked related pathologies have been identified.
The Igenomix Hydrops Fetalis Syndrome Precision Panel can be used to make a directed and accurate diagnosis ultimately leading to a better management and prognosis of the disease. It provides a comprehensive analysis of the genes involved in this disease using next-generation sequencing (NGS) to fully understand the spectrum of relevant genes involved.
The clinical utility of this panel is:
GENE | OMIM DISEASES | INHERITANCE* | % GENE COVERAGE (20X) | HGMD** |
A2ML1 | Noonan | AD,MU,P | 100 | 23 of 23 |
ADA2 | Childhood- | AR | 100 | NA of NA |
ADAMTS3 | Hennekam | AR | 99.97 | 4 of 4 |
AGGF1 | Klippel-trenaunay |
| 99.96 | 1 of 1 |
AHCY | Hypermethioninemia | AR | 100 | 11 of 11 |
ALG1 | Congenital Disorder | AR | 100 | 46 of 46 |
ALPK3 | Familial Hypertrophic | AR | 97.29 | 7 of 7 |
ASAH1 | Farber | AR | 99.98 | 69 of 70 |
BRAF | Cardiofaciocutaneous | AD | 100 | 80 of 80 |
BSND | Infantile Bartter | AR | 99.95 | 21 of 21 |
CALCRL | Lymphatic | AR | 99.89 | 1 of 1 |
CARS2 | Combined | AR | 99.14 | 6 of 6 |
CASP10 | Autoimmune | AD | 99.86 | 6 of 6 |
CBL | Juvenile | AD | 100 | 46 of 47 |
CCBE1 | Hennekam | AR | 100 | 16 of 16 |
CDAN1 | Dyserythropoietic | AR | 99.59 | 68 of 68 |
COL11A1 | Fibrochondrogenesis, | AD,AR | 100 | 104 of 106 |
COL1A1 | Caffey Disease, | AD | 99.98 | 1156 of 1159 |
COL1A2 | Osteogenesis | AD,AR | 100 | 576 of 581 |
COL2A1 | Achondrogenesis | AD,MU | 100 | 583 of 583 |
CTSA | Neuraminidase | AR | 100 | 40 of 40 |
DYNC2H1 | Short-Rib Thoracic | AR,MU,D | 99.78 | 214 of 221 |
DYNC2I1 | Short-Rib Thoracic | AR | 97.76 | 14 of 14 |
DYNC2I2 | Short-Rib Thoracic | AR | 99.54 | 23 of 23 |
EPB41 | Hereditary | AD,AR | 99.69 | 11 of 11 |
EPHB4 | Capillary Malformation- | AD | 100 | 65 of 65 |
FAS | Autoimmune | AD | 100 | 135 of 135 |
FASLG | Autoimmune | AD | 99.98 | 8 of 9 |
FAT4 | Hennekam | AR | 99.8 | 41 of 41 |
FIG4 | Amyotrophic Lateral | AD,AR | 99.92 | 72 of 72 |
FLNB | Atelosteogenesis, | AD,AR | 100 | 124 of 124 |
FLT4 | Congenital Heart Defects, | AD | 100 | 119 of 120 |
GATA1 | X-linked Anemia With | X,XR,G | 99.93 | NA of NA |
GATB | Combined Oxidative | AR | 99.98 | NA of NA |
GATC | Combined Oxidative | AR | 100 | 1 of 1 |
GBA | Perinatal Lethal | AD,AR | 100 | 469 of 471 |
GBE1 | Glycogen Storage | AR | 99.95 | 71 of 74 |
GRIP1 | Fraser | AR | 100 | 17 of 17 |
GUSB | Mucopolysaccharidosis, | AR | 100 | 65 of 66 |
GYPC | Hereditary |
| 100 | 1 of 1 |
HADHA | Long-Chain | AR | 100 | 75 of 75 |
HADHB | Mitochondrial | AR | 99.99 | 66 of 68 |
HBA1 | Alpha-Thalassemia, | AD | 98.87 | 125 of 152 |
HBA2 | Alpha-Thalassemia, | AD | 74.46 | 118 of 231 |
IFT80 | Asphyxiating Thoracic | AR | 99.96 | 16 of 16 |
KIAA0586 | Joubert Syndrome, | AR | 99.84 | 31 of 32 |
KLF1 | Dyserythropoietic | AD | 99.76 | 48 of 50 |
KRAS | Aplasia Cutis Congenita | AD | 100 | 38 of 38 |
LBR | Hydrops-Ectopic | AD,AR | 99.98 | 34 of 34 |
LZTR1 | Noonan | AD | 99.99 | 136 of 136 |
MAP2K1 | Cardiofaciocutaneous | AD | 100 | 31 of 31 |
MAP2K2 | Cardiofaciocutaneous | AD | 100 | 37 of 37 |
MRAS | Noonan | AD | 100 | 3 of 3 |
NEK1 | Amyotrophic | AD,AR,MU,D | 99.83 | 73 of 74 |
NEK9 | Arthrogryposis, | AR | 99.98 | 4 of 4 |
NEU1 | Neuraminidase | AR | 100 | 68 of 68 |
NF1 | Juvenile | AD | 97.97 | 3082 of 3166 |
NRAS | Noonan Syndrome, | AD | 100 | 15 of 15 |
PIEZO1 | Dehydrated | AD,AR | 99.98 | 107 of 107 |
PIGA | Multiple Congenital | X,XR,G | 97.98 | NA of NA |
PKLR | Elevated Adenosine | AD,AR | 100 | 283 of 285 |
PLD1 | Developmental | AR | 99.98 | 4 of 4 |
PMM2 | Congenital Disorder | AR | 100 | 127 of 129 |
PPP1CB | Noonan Syndrome-like | AD | 99.87 | 12 of 12 |
PRKCD | Common Variable | AR | 100 | 9 of 9 |
PTH1R | Chondrodysplasia, | AD,AR | 100 | 48 of 48 |
PTPN11 | Juvenile Myelomonocytic | AD | 100 | 150 of 151 |
QRSL1 | Combined Oxidative | AR | 99.91 | 6 of 7 |
RAF1 | Dilated Cardiomyopathy, | AD | 100 | 64 of 64 |
RASA2 | Noonan |
| 99.82 | 5 of 5 |
RASGRP1 | Immunodeficiency, | AR | 98.41 | 8 of 9 |
RIT1 | Noonan | AD | 99.85 | 27 of 27 |
RPL11 | Diamond-Blackfan | AD | 100 | 52 of 52 |
RPL15 | Diamond-Blackfan | AD | 99.74 | 8 of 9 |
RPL18 | Diamond-Blackfan | AD | 100 | 1 of 1 |
RPL26 | Diamond-Blackfan | AD | 92.97 | 1 of 1 |
RPL27 | Diamond-Blackfan | AD | 100 | 2 of 2 |
RPL31 | Diamond-Blackfan |
| 100 | 0 of 1 |
RPL35 | Diamond-Blackfan | AD | 100 | 1 of 1 |
RPL35A | Diamond-Blackfan | AD | 100 | 12 of 12 |
RPL5 | Diamond-Blackfan | AD | 100 | 95 of 95 |
RPS10 | Diamond-Blackfan | AD | 100 | 7 of 7 |
RPS15A | Diamond-Blackfan | AD | 98.74 | 1 of 1 |
RPS17 | Diamond-Blackfan | AD | 0 | 0 of 7 |
RPS19 | Diamond-Blackfan | AD | 78 | 159 of 165 |
RPS24 | Diamond-Blackfan | AD | 90.17 | 11 of 14 |
RPS26 | Diamond-Blackfan | AD | 100 | 28 of 29 |
RPS27 | Diamond-Blackfan | AD | 99.85 | 1 of 1 |
RPS28 | Diamond-Blackfan | AD | 100 | 1 of 1 |
RPS29 | Diamond-Blackfan | AD | 100 | 4 of 4 |
RPS7 | Diamond-Blackfan | AD | 100 | 7 of 10 |
RRAS | Noonan |
| 95.86 | 3 of 3 |
RRAS2 | Noonan | AD | 99.8 | 6 of 6 |
RYR1 | Central Core Disease | AD,AR | 97.63 | 733 of 746 |
SHOC2 | Noonan Syndrome-like | AD | 99.98 | 8 of 8 |
SLC17A5 | Infantile Sialic Acid | AR | 99.91 | 49 of 49 |
SLC26A2 | Achondrogenesis, | AR | 99.59 | 51 of 56 |
SOS1 | Noonan Syndrome, | AD | 100 | 103 of 104 |
SOS2 | Noonan | AD | 99.48 | 6 of 7 |
SOX18 | Hypotrichosis– | AD,AR | 67.33 | 5 of 7 |
SPTA1 | Hereditary Elliptocytosis, | AD,AR | 100 | 106 of 107 |
SPTB | Hereditary Elliptocytosis, | AD | 100 | 152 of 152 |
TALDO1 | Transaldolase | AR | 95 | 13 of 14 |
TAPT1 | Complex Lethal | AR | 89.49 | 3 of 3 |
TRIP11 | Achondrogenesis, | AR | 98.94 | 20 of 21 |
TSR2 | Diamond-Blackfan | X,XR,G | 99.96 | NA of NA |
UROS | Congenital | AR | 100 | 44 of 50 |
VAC14 | Childhood-Onset Striatonigral | AR | 100 | 11 of 11 |
WDR35 | Cranioectodermal | AR | 100 | 31 of 33 |
WNT7A | Fibular | AR | 100 | 10 of 10 |
* Inheritance: AD: Autosomal Dominant; AR: Autosomal Recessive; X: X linked; XLR: X linked Recessive; Mi: Mitochondrial; Mu: Multifactorial
** HGMD: Number of clinically relevant mutations according to HGMD
Waring, G. J., Splitt, M., & Robson, S. C. (2019). Fetal hydrops: diagnosis and prognosis. Archives of disease in childhood, 104(3), 209–210. https://doi.org/10.1136/archdischild-2018-315777
Mardy, A. H., Chetty, S. P., Norton, M. E., & Sparks, T. N. (2019). A system-based approach to the genetic etiologies of non-immune hydrops fetalis. Prenatal diagnosis, 39(9), 732–750. https://doi.org/10.1002/pd.5479
Bellini, C., & Hennekam, R. (2012). Non-immune hydrops fetalis: A short review of etiology and pathophysiology. American Journal Of Medical Genetics Part A, 158A(3), 597-605. doi: 10.1002/ajmg.a.34438
Sparks, T. N., Thao, K., Lianoglou, B. R., Boe, N. M., Bruce, K. G., Datkhaeva, I., Field, N. T., Fratto, V. M., Jolley, J., Laurent, L. C., Mardy, A. H., Murphy, A. M., Ngan, E., Rangwala, N., Rottkamp, C., Wilson, L., Wu, E., Uy, C. C., Valdez Lopez, P., Norton, M. E., … University of California Fetal–Maternal Consortium (UCfC) (2019). Nonimmune hydrops fetalis: identifying the underlying genetic etiology. Genetics in medicine : official journal of the American College of Medical Genetics, 21(6), 1339–1344. https://doi.org/10.1038/s41436-018-0352-6
Désilets, V., Audibert, F., Wilson, R., Audibert, F., Brock, J., & Carroll, J. et al. (2013). Investigation and Management of Non-immune Fetal Hydrops. Journal Of Obstetrics And Gynaecology Canada, 35(10), 923-936. doi: 10.1016/s1701-2163(15)30816-1
Jauniaux E. (1997). Diagnosis and management of early non-immune hydrops fetalis. Prenatal diagnosis, 17(13), 1261–1268. https://doi.org/10.1002/(sici)1097-0223(199712)17:13<1261::aid-pd292>3.0.co;2-c