Diagnostic aspects of neonatal ascites: report of 27 cases

Griscom, N. Thorne; Colodny, Arnold H.; Rosenberg, Henrietta Kotlus; Fliegel, C P; Hardy, Brian

doi:10.2214/ajr.128.6.961

Cited by 79 publications

(32 citation statements)

References 34 publications

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“…The natural history of isolated ascites still remains unclear. The etiology includes chromosomal anomalies, intrauterine infections and structural anomalies commonly involving the gastrointestinal, genitourinary or cardiac system [1,2]. Transitory ascites without an identifiable cause, which resolves pre-or postnatally, has also been described [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Etiology and Prognosis of Fetal Ascites

et al. 2003

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Objective: To examine the prenatal course and outcomes of neonates with isolated fetal ascites. Methods: A retrospective analysis (from 1990 through 2000) was performed on 26 consecutive cases presenting with fetal ascites. A systematic diagnostic protocol which included fetal blood sampling for karyotyping, serology and serial ultrasound examinations to determine etiology was followed in all cases after diagnosis. Pregnancy outcome was assessed by a chart report or autopsy reports. Results: The majority of cases were associated with fetal malformations (n = 11). Five fetuses had malformations with associated syndromes. Less commonly associated were intrauterine infections (n = 3), intestinal perforation (n = 2), genetic disorders (n = 2), neoplasm (n = 1) and growth retardation (n = 1). In only 1 case (4%) was the etiology idiopathic. Secondary generalized hydrops occurred only in 4 of 26 cases. Only 13 of 16 liveborn infants survived past the neonatal period and only 4 cases are doing well at childhood age without any sequelae. Conclusion: A wide range of etiologies were associated with isolated fetal ascites. Those with malformations had the worst pregnancy outcome. Prenatal diagnosis was made in 92% utilizing a systematic diagnostic workup. The diagnosis of idiopathic ascites has become rare due to the improvement in prenatal diagnosis.

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Section: Introductionmentioning

confidence: 99%

Etiology and Prognosis of Fetal Ascites

et al. 2003

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“…[3,4]. However, the absence of any previous history regarding the gastrointestinal, hepatic or cardiac system, in association with the rapid accumulation of fluid after the catheterization, as well as the findings of renal failure with marked hyponatremia, raised the suspicion of bladder perforation in our patient.…”

Section: Case Presentationmentioning

confidence: 77%

Life-Threatening Hyponatremia and Acute Renal Failure due to Iatrogenic Neonatal Bladder Rupture

et al. 2011

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Neonatal urinary ascites is a rare entity, usually associated with a spontaneous rupture of the bladder with an underlying pathology such as high pressure or wall disruption. Its presentation involves abdominal distension, metabolic derangement and respiratory compromise. We report the case of a male neonate with solitary functioning kidney presented with life-threatening persistent hyponatremia and acute renal failure due to iatrogenic bladder rupture after catheterization. The aim of our report is to raise awareness on the possibility of bladder perforation in neonates even in the absence of technical faults. We discuss the uncommon presentation of our case and highlight the need for early recognition and management of urinary ascites, addressing all subspecialties involved in diagnostic or therapeutic procedures of neonates with urinary abnormalities.

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“…1 The most common cause of isolated fetal ascites is urinary obstruction, particularly posterior urethral valves and less commonly urethral atresia. 2,3 Most of these cases are associated with oligohydramnios. Approximately 60 to 70% of cases of fetal ascites are due to urinary tract obstruction.…”

Section: Denouement and Discussionmentioning

confidence: 99%