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What's already known about this topic? Nonimmune fetal hydrops (NIFH) is a heterogeneous condition and establishing a diagnosis can be challenging. Inborn errors of metabolism are one of many possible etiologies for NIFH. Inborn errors of metabolism are often missed in utero. What does this study add? We present two cases of NIFH caused by underlying lysosomal storage disease: galactosialidosis and mucopolysaccharidosis type VII. The unique finding of vacuolated lymphocytes in fetal peritoneal fluid lead to the diagnosis.

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