Antenatal Management of Second Trimester Oligohydramnios and Evolving Abnormal Ultrasound Findings: Case Report

Abstract

Appropriate patient selection for prenatal intervention in the setting of abnormal antenatal ultrasound findings remains challenging. This case illustrates the course of a complicated pregnancy in a 35-year-old gravida 1 para 0 who presented to our Maternal-Fetal-Medicine clinic at 24.2 weeks gestation with fetal ascites, scalp edema, and oligohydramnios. Her first trimester ultrasound and genetic screening was normal. The patient was counseled that the observed findings carried a high chance for fetal demise or postnatal birth defects and complications. The patient chose to continue the pregnancy and opted for any necessary fetal interventions. Throughout the course of her pregnancy, multiple therapeutic interventions were performed in order to maintain a stable fetal environment, including intrauterine paracentesis, transabdominal amnioinfusion, vesicocentesis, and placement of a peritoneal amniotic shunt. The purpose of this case report is to investigate the role of fetal intervention in second trimester abnormal ultrasound findings and improve the quality of future prenatal consultation and therapy.