Adipophilin immunostain in adrenal cortex, reflecting fetal distress in hydrops fetalis

Aim The distribution of lipid in the fetal adrenal cortex is reported to correlate with the duration of hypoxia and degree of fetal stress. The objective of this study is to investigate the distribution of lipid in the fetal adrenal cortex in hydrops fetalis (HF) of different etiologies, using immunostaining for adipophilin on formalin-fixed material. Materials and methods Adrenal gland tissues belonging HF fetuses were stained with adipophilin. The etiologies of HF were classified as hemoglobin (Hb) Bart vs HF due to other causes. Results There were 20 and 34 cases of Hb Bart and HF due to other causes, respectively. In the fetal zone, lipid distribution was more diffuse in Hb Bart HF compared to other causes of HF including those due to anemia. In the definitive cortex, a greater degree of cystic degeneration correlated with lower gestational age, rather than the specific etiology of HF. Discussion 1) Increased lipid in the fetal zone is associated with severity of hypoxia. 2) Cystic degeneration is more a reflection of the onset of fetal stress rather than severity.