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Hepatitis E virus infection causing isolated fetal ascites: a case report.
Mandakini Pradhan1, Bhavna Anand, Asha Singh
1Department of Maternal and Reproductive Health, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. mandakini_pradhan@rediffmail.com
Fetal Diagnosis and Therapy
|June 9, 2012
Summary
Maternal hepatitis E virus infection in pregnancy can cause fetal ascites. This case shows spontaneous resolution of fetal ascites, leading to a healthy baby with HEV antibodies.
Area of Science:
- Hepatology
- Maternal-Fetal Medicine
- Virology
Background:
- Maternal hepatitis infections, excluding hepatitis E, have been linked to fetal ascites.
- The outcomes associated with fetal ascites due to maternal hepatitis infections are variable.
Observation:
- A case of a 39-year-old primigravida diagnosed with acute hepatitis E virus (HEV) infection at 15 weeks gestation.
- Ultrasound revealed significant fetal ascites and abdominal calcifications at 19 weeks, with normal fetal karyotype.
- Cord blood tested positive for anti-HEV IgM, indicating intrauterine HEV exposure.
Findings:
- Isolated fetal ascites demonstrated partial resolution by 25 weeks gestation and complete resolution by 30 weeks.
- The pregnancy resulted in a healthy, term live-born infant at 38 weeks gestation.
- The infant exhibited normal liver enzymes at birth and during a 1-month follow-up, with anti-HEV seropositivity.
Implications:
- Hepatitis E virus infection during pregnancy can lead to fetal ascites.
- Spontaneous resolution of fetal ascites caused by HEV infection is possible.
- HEV infection in pregnancy may result in a healthy infant with evidence of seroconversion.
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