An unusual case of postoperative ascites after cesarean section

Abstract

Post-operative ascites following caesarean section is rarely reported in pregnancy. Ascites has multiple etiologies including malignancies, liver cirrhosis, intraperitoneal infections and trauma. Authors report a case of post-operative ascites following caesarean section performed at around 37 weeks of gestation. The patient was normotensive. The diagnosis and treatment of ascites as well as the pregnancy outcome is presented. Literature review of ascites in pregnancy is discussed as well. This case was that of an idiopathic ascites with no definitive cause. An allergic or inflammatory peritoneal reaction may be the most likely cause for this complication.

Massive ascites following spontaneous vaginal delivery in a woman with preeclampsia-a diagnostic and management challenges in a low resource country: A case report

“…This case highlights the challenges faced by the obstetricians working in the low resource setting in recognizing and managing obstetric complications. The finding from this case adds to the already existing literature that the ascites in severe pre-eclampsia should be treated medically [ 4 , 8 ].…”

“…The basic patho-physiology involves the release of vasoconstrictive agents, endothelial damage, hyperpermeability of the capillaries and microangiopathic hemolysis [ 3 , 6 ]. Ascites is reported antenatally, after normal delivery and after cesarean section in the postpartum period, as well as during cesarean section in women with preeclampsia [ [4] , [5] , [6] , 8 , 9 ]. There are case reports of postpartum ascites caused by bladder rupture following vaginal delivery [ 10 ], tuberculosis peritonitis [ 11 ], idiopathic chylous ascites [ 12 ], pregnancy specific liver disease [ 13 ], lupus peritonitis [ 14 ], etc.…”

“…In another case report, 32-year-old developed ascites after emergency cesarean section. She was managed with paracentesis to relieve symptoms in combination with medical treatment with Aldactone, high protein diet and low salt diet [ 8 ].…”

Laparoscopic approach in postpartum pyoperitoneum: A guide to early rehabilitation

“…Laparoscopy offers a 360°evaluation, and also excellent visualization of hard-to-reach areas, and is recommended over laparotomy by several authors. [8][9][10] The theoretical risk of laparoscopy over laparotomy of hypercapnia and increased intrabdominal pressure is rarely seen. 11 Obviously, familiarity with the laparoscopic approach is fundamental.…”

Amniotic Fluid Embolism After First-Trimester Abortion

“…In our case, ascites are often explained as an inflammatory reaction within the peritoneum due to an anaphylactoid reaction. Sandhu et al reported that post caesarean idiopathic ascites with no definitive cause, allergic or inflammatory peritoneal reaction could also be the foremost likely cause for this complication [ 4 ].…”