Congenital Cytomegalovirus Infection Associated with Fetal Ascites and Intrahepatic Calcifications

Abstract

A fetus at 20 weeks' gestation was shown by ultrasonography to have ascites and intrahepatic calcifications. We aspirated the fetal ascites at 29 and 30 weeks' gestation to decompress the fetal lungs due to the progression of the ascites and the concomitant compression in the fetal lungs. The newborn had neither hypoplasia of the lungs nor any respiratory complication, though congenital cytomegalovirus infection was present. This is the first report of such congenital cytomegalovirus infection associated with fetal ascites and intrahepatic calcifications. Careful monitoring and early intervention is necessary for a good prognosis.

Hepatic calcifications in a fetus with trisomy 9 that underwent cordocentesis

“…In rare cases, hepatitis is followed by numerous post-inflammatory dystrophic calcifications, which may also be found in other organs. This has been observed with toxoplasmosis, herpes virus, and cytomegalovirus infections (Shackelford and Kirks, 1977;Yamashita et al, 1989). Fetal tumours of the liver, both benign and malignant, such as haemangiomas, hepatic hamartomas, teratomas, hepatoblastomas, and metastatic neuroblastomas, commonly contain areas of irregular calcifications (Benjamin et al, 1981;Nguyen and Leonard, 1986).…”

Fetal ascites owing to congenital cytomegalovirus: response to ganciclovir

“…10 Congenital CMV infection can present with ascites along with other hepatic problems such as intrahepatic calcifications, hepatic fibrosis and portal hypertension. 4,5 As both of the latter cases were associated with pulmonary hypoplasia, the prognosis was poor. Binder D et al reported isolated fetal ascites with CMV infection.…”

“…2 Congenital CMV infection presenting with fetal ascites is uncommon. [3][4][5] We report an infant who presented with fetal and neonatal ascites along with other features of congenital CMV infection and describe the response to ganciclovir.…”

Pathophysiology, Diagnosis, and Management of Pediatric Ascites

“…Ascites is typically detected at a gestational age between FIGURE 1. Histologic examination of severely infected fetal livers has shown hepatocellular degeneration with extensive bridging fibrosis and intrahepatic calcifications (24). Hepatic lymph is formed by filtration of sinusoidal plasma into the space of Disse.…”