Causes of Fetal Ascites
· Hydrops fetalis- Fetal ascites may occur as a part of hydrops.
· Hematologic-The hematologic causes of fetal ascites include: Rh isoimmunization, fetal hemoglobinopathy, G6PD deficiency, fetal hemorrhage, twin—twin transfusion and anemia due to maternal acquired pure red cell aplasia.
· Infections-Transpiacental infections that have been associated with fetal ascites include coxsackie, CMV, parvovirus, RSV, herpes simplex type I, toxoplasmosis and syphilis.
· Gastrointestinal-Causes include bowel atresias, volvulus, meconium peritonitis and bowel obstruction with perforation.
· Genitourinary-Urinary tract obstruction with perforation.
· Cardiovascular- Ascites may complicate fetal congestive cardiac failure, or any major congenital heart disease.
· Metabolic- Storage diseases and other metabolic disorders, e.g. Gaucher’s disease, mucopolysaccharidosis.
· Hepatobiliary-Congenital hepatic tumors, hepatitis in utero and biliary atresia.
· Abdominal neoplasia-Mostly intra-abdominal tumors but extra-abdominal tumors such as neuroblastoma and teratoma have also been associated with ascites.
· Respiratory- Ascites may complicate any major pulmonary abnormality, including congenital cystic adenomatoid malformation, pulmonary lymphangiectasia, congenital tumors, extralobar sequestration, chylothorax, diaphragmatic hernia or enlargement of one lung, by obstructing venous return to the right atrium.
· Psudoascites-This represents an artifact and is seen as a linear lucency beneath the skin on the lateral part of the abdomen. This artifact is said to relate to the cone-like shape of the fetal abdomen with a contribution from the muscles of the abdominal wall.
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