Ascites

Juan Carlos Quintero, MD

Universidad del Valle - Cali - Colombia

This is a 26-year-old woman, G2P1, referred to our unit for an anomaly scan at 20 weeks. In the previous pregnancy, she had a baby with growth restriction and a single umbilical artery. The karyotype was normal (46XY, 2200g). The baby is now 5-year-old and with a normal development.

In the first scan, the ultrasound findings were:

  • ascites
  • an interventricular septal defect (perimembranous type)
  • borderline ventriculomegaly (10mm).
  • The biometry was concordant with the gestational age except the abdominal circumference that it was over the┬ápercentile 95.
  • The ductus venosus could not see recognize.

A Down syndrome or TORCH infections were suspected. Karyotype was normal 46 XY. The serological test were also negative. In the second scan, the interventricular septal defect could not be recognize anymore.

Serial scans were performed. The ductus venosus could be seen only at 31 weeks. Polyhydramnios was present. Due to a preterm labor, indomethacin and corticoids were prescribed. The ascites developed until 34 weeks, when a spontaneous resolution occurred.

The baby was born at 37 weeks (3200g, Apgar 9/10) with a mild hepatomegaly. No splenomegaly was present. The postnatal serological tests and liver enzymes were normal. An echocardiogram showed mild dilatation of right cavities and a mild pericardium effusion. The baby developed without complications.

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Scan at 20 weeks. Note the ascites and the ultrasound findings suggestive of a ventricular septal defect

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Ascites at 26 weeks

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Normal four chamber view at 27 weeks

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Scan at 30 weeks

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Scan at 31 weeks

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Scan at 33 weeks

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View at 34 weeks. Note the spontaneous resolution of the ascites

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View at 36 weeks

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