Zelop C, Benacerraf B R
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts.
Prenat Diagn. 1994 Oct;14(10):941-6. doi: 10.1002/pd.1970141008.
The purpose of this study was to examine the natural history and differential diagnosis of ultrasound-detected, isolated fetal ascites. Retrospective review of our patient data base, from 1989 to 1993, revealed 18 patients with fetal ascites diagnosed sonographically. Fetuses presenting with generalized hydrops were excluded. One of the 18 fetuses with ascites had a chromosomal abnormality (trisomy 21), four fetuses had intrauterine infections, seven had gastrointestinal processes, two had genitourinary tract abnormalities, and four were labelled as 'idiopathic' (all four resulting in normal neonates). Seventeen of 18 fetuses survived; there was one fetal demise secondary to active syphilis. One fetus with parvovirus infection required intrauterine transfusion and did well. Two infants are developmentally retarded, including one with trisomy 21 and one with microcephaly secondary to cytomegalovirus infection. Fourteen of 18 fetuses had documented in-utero resolution of the ascites. Eleven of the 18 were associated with polyhydramnios sometime during fetal life. None of the fetuses developed hydrops. In conclusion, fetal ascites can result from many different aetiologies, including gastrointestinal and genitourinary anomalies. Chromosomal abnormalities and viral aetiologies must also be considered. Fetuses who have isolated ascites can have a good outcome with resolution of the ascites antenatally.
本研究的目的是探讨超声检测到的孤立性胎儿腹水的自然病史及鉴别诊断。回顾1989年至1993年我们的患者数据库，发现18例经超声诊断为胎儿腹水的患者。排除表现为全身性水肿的胎儿。18例腹水胎儿中有1例存在染色体异常（21三体），4例有宫内感染，7例有胃肠道病变，2例有泌尿生殖道异常，4例被标记为“特发性”（这4例均产出正常新生儿）。18例胎儿中有17例存活；有1例因活动性梅毒导致胎儿死亡。1例感染细小病毒的胎儿需要宫内输血，情况良好。2例婴儿发育迟缓，其中1例患有21三体，1例因巨细胞病毒感染导致小头畸形。18例胎儿中有14例记录到宫内腹水消退。18例中有11例在胎儿期的某个时候伴有羊水过多。所有胎儿均未发展为水肿。总之，胎儿腹水可由多种不同病因引起，包括胃肠道和泌尿生殖道异常。还必须考虑染色体异常和病毒病因。孤立性腹水的胎儿在产前腹水消退后可获得良好结局。
