Autopsy on a stillborn fetus reveals cardiomegaly, hepatomegaly, edema, and ascites as well as fulminant intrauterine congestive heart failure. Considering these findings, what is the most likely cause of death?
a. Alpha thalassemia minor
b. Alpha thalassemia major
c. Hemoglobin H disease
d. Alpha trait
ANS: B
Alpha thalassemia major causes hydrops fetalis and fulminant intrauterine congestive heart fail-ure. In addition to edema and massive ascites, the fetus has a grossly enlarged heart and liver. These findings are not associated with alpha thalassemia minor, hemoglobin H disease, or alpha trait, which is the mildest form of the disease.
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