Etiology and Prognosis of Fetal Ascites

Abstract

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.

Fetal ascites and hydrometrocolpos due to persistent urogenital sinus and cloaca: a rare congenital anomaly and review of literature

“…Thus, a systematic protocol should be followed to find the underlying cause, as an aetiology can be identified in 92% of the cases 8 9. As fetal ascites is an important associate of fetal hydrops, it is important to determine whether it is isolated or whether other signs of hydrops are present and investigations like Coomb's test and TORCH profile should be conducted.…”

Prenatal rectal perforation: an unsuspected cause of isolated ascites

“…The differential diagnosis list includes cystic fibrosis, Hirschsprung disease, vascular insufficiency, infection and bowel occlusion owing to small and large bowel atresia, midgut volvulus, intussusception, congenital bands and meconium ileus. [5][6][7][8][9][10] Each of these possible causes was excluded in the present patient. As a prenatal sigmoid perforation following amniocentesis has been reported, 11 we investigated the circumstances of the early amniocentesis in this patient and found no evidence for complications during and after its execution.…”

Voluminous Fetal Chylous Ascites: A Case of Complete Spontaneous Prenatal Regression

“…Other causes of fetal ascites (e.g. chromosomal, metabolic, infectious) should be sought systematically [19] . Chylous ascites in a fetus or newborn may be caused by an obstruction or compression of lymphatic vessels, a wound, fistula, exudative enteropathy or exudate from the wall of the retroperitoneal lymphatics [1] .…”