This whole body radiograph reveals marked soft tissue thickening, particularly evident around the skull, in this preterm baby with hydrops fetalis from congestive heart failure. This baby was the recipient twin of a twin-to-twin transfusion syndrome. There is also a left pneumothorax as a result of intubation and positive pressure ventilation required in resuscitation efforts because of severe pulmonary hypoplasia. An umbilical artery catheter is in place (the proximal end has been tied off).