[Non-immunologic fetal ascites and anasarca. Apropos of 44 cases]

Between January 1980 and July 1987 there were 44 cases of fetal non-immune ascites and generalised oedema. These are presented. This pathological condition which occurs rarely (1/1,600 to 1/3,500), is considered by most authors to have a very high mortality (80-95%). An aetiological study shows that for the main part the causes are fetal (75%) and among those there is an important place for cardiac abnormalities (20.4%). These are principally faults in fetal cardiac rhythm. The second most common abnormalities are chromosomal (13.6%). These should be sought out by ultrasound. A typical malformation should lead to karyotyping. Idiopathic cases (9%) are fewer comparatively than in old series because of more accurate investigation. 34% survived out of the whole series of all the pathological conditions together. The only way to arrive at accurate antenatal diagnosis is by looking hard for the aetiological causes. These, when found, will show the way to handle the cases both obstetrically and after delivery. It will also help to identify the prognosis and to improve the chances of survival for those fetuses that can be saved.