Causes of Fetal splenomegaly
· Transplacental infections- These include viral infections such as CMV, rubella, coxsackie and infections with toxoplasma and syphilis.
· Hematologic disorders- These include Rh incompatibility, hemolytic and other anemias, often associated with FH.
· Congestive cardiac failure- This may be associated with major cardiac defects, cardiomegaly or arrythmias.
· Metabolic disorders/storage diseases- Gaucher’s disease, Niemann—Pick disease, Wolman’s disease, hypothyroidism and galactosemia.
· Beckwith Wiedemann syndrome- Associated with visceromegaly and skeletal anomalies.
· Space occupying lesions of spleen- Splenomegaly has been identified with splenic cysts and hamartomas.
· Congenital neoplasia/malignancy- Splenomegaly has been reported in association with congenital leukemia, lymphoma and histiocytosis.
NB- The spleen can be identified in most fetuses between 18 and 40 weeks. In the fetus the spleen is of similar echogenicity as the kidney. Ectopic spleen lying below the right kidney has been reported in a fetus with omphalocele.
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