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Fetal Ascites: Its Prenatal Management and Postnatal Outcome
Khushboo Malhotra1, Rinshi Abid Elayedatt1, Vivek Krishnan1
1Department of Fetal Medicine, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala 682041 India.
Journal of Obstetrics and Gynaecology of India
|January 6, 2025
Summary
Idiopathic fetal ascites cases showed better outcomes than secondary causes. Early diagnosis and multidisciplinary management are key for improving fetal ascites survival rates.
Area of Science:
- Perinatal Medicine
- Fetal Surgery
- Neonatology
Background:
- Fetal ascites, the accumulation of fluid in fetal body cavities, presents diagnostic and management challenges.
- Understanding the etiology and predicting outcomes of fetal ascites is crucial for prenatal counseling and intervention.
Purpose of the Study:
- To evaluate the management and postnatal outcomes of prenatally diagnosed fetal ascites.
- To compare outcomes between idiopathic and secondary fetal ascites.
- To identify factors influencing survival and spontaneous resolution.
Main Methods:
- Retrospective analysis of 56 cases of fetal ascites diagnosed between 2015 and 2022.
- Inclusion criteria: fetuses without hydrops fetalis at diagnosis.
- Data collection included gestational age, etiology, interventions, and postnatal outcomes.
Main Results:
- A majority of cases (76.8%) had secondary causes, including twin-to-twin transfusion syndrome (TTTS) and fetal growth restriction (FGR).
- Overall survival rate was 77.4%.
- Idiopathic ascites had a higher rate of favorable outcomes (63.6%) compared to secondary ascites (41.5%).
Conclusions:
- Fetuses with idiopathic ascites and normal karyotype/negative infection screening show a better prognosis.
- Postnatal outcomes for secondary ascites can be improved with intervention.
- Multidisciplinary team management is essential for optimal fetal ascites care.
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