Schmider Annette, Henrich Wolfgang, Reles Angela, Kjos Siri, Dudenhausen Joachim W
Division of Prenatal Diagnosis and Therapy, Department of Obstetrics and Gynecology, Charité, Campus Virchow-Klinikum, Humboldt University of Berlin, Germany.
Fetal Diagn Ther. 2003 Jul-Aug;18(4):230-6. doi: 10.1159/000070801.
To examine the prenatal course and outcomes of neonates with isolated fetal ascites.
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.
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.
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.
研究孤立性胎儿腹水新生儿的产前病程及结局。
对连续26例胎儿腹水病例进行回顾性分析（1990年至2000年）。所有病例诊断后均遵循系统的诊断方案，包括采集胎儿血液进行染色体核型分析、血清学检查及系列超声检查以确定病因。通过图表报告或尸检报告评估妊娠结局。
大多数病例与胎儿畸形有关（n = 11）。5例胎儿有畸形并伴有综合征。较少见的相关因素有宫内感染（n = 3）、肠穿孔（n = 2）、遗传疾病（n = 2）、肿瘤（n = 1）和生长迟缓（n = 1）。仅1例（4%）病因不明。26例中仅4例发生继发性全身水肿。16例活产婴儿中仅13例存活至新生儿期以后，儿童期仅有4例情况良好且无任何后遗症。
多种病因与孤立性胎儿腹水有关。伴有畸形者妊娠结局最差。采用系统的诊断检查，92%的病例可作出产前诊断。由于产前诊断的改善，特发性腹水的诊断已变得罕见。
