An unusual cause of neonatal ascites

Description

A 30-year-old primigravida was referred to our institution due to an isolated fetal ascites (IFA). The gestation was uneventful until the 32nd week when the mother was hospitalised due to refractory hypertension. An ultrasound revealed a fetal abdominal circumference above percentile 99. Fetal parameters and amniotic fluid volume were normal.and

The investigation of IFA was started on the mother: blood type was ARh+, indirect Coombs test and infectious serology (toxoplasmosis, syphilis, varicella-zoster, parvovirus B19, rubella, cytomegalovirus and herpes (TORCH)) were negative.

A spontaneous vaginal delivery occurred at 34 weeks. As the ascites compromised ventilation, the neonate was intubated and an urgent paracentesis was performed evacuating 175 mL of a transudate, and thereafter, the caucasian female neonate with 2235 g was stable with spontaneous breathing.

As the ascites persisted, the investigation continued on the neonate: blood group ARh+, negative direct Coombs test and normal echocardiography. Abdominal ultrasound showed dilated bowel loops. The abdominal X-ray...

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