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Abstract
Discussion Forum (0)
Introduction: Fetal ascites is defined as the presence of fluid within the fetal peritoneal cavity. Fetal ascites may occur alone as isolated fetal ascites or be diagnosed as part of fetal hydrops. Our objective was to identify the genitourinary causes of isolated fetal ascites and associated outcomes.
Methods: We did a systematic literature review using Scopus, PubMed, and the Cochrane Library from inception through February 2020. Case series with >5 cases of isolated fetal ascites were eligible for inclusion. Cases of fetal ascites identified as part of fetal hydrops at presentation were excluded. Cases of isolated fetal ascites with genitourinary etiology were included in our analysis.
Results: 70 cases of isolated fetal ascites with genitourinary etiology were identified. This included posterior urethral valves (PUV) (20/70, 29%), Potter syndrome (3/70, 4.3%), vesicoureteral reflux (2/70, 2.9%), ureteropelvic junction obstruction (2/70, 2.9%), other genitourinary disorders (7/70, 10%) and in 36/70 cases (51%), the specific disorder was not reported. There were no cases of progression to fetal hydrops reported. Outcome data was available for 68/70 cases: 32/68 (47%) live births, 3/68 (4%) neonatal death, 5/68 (7%) intrauterine fetal demise and 28/68 (41%) had pregnancy termination.
Conclusion/Implications: A variety of genitourinary pathology can result in isolated fetal ascites with PUV being the most common. Neonatal survival is 80% amongst continuing pregnancies. Survival rate may be overestimated due to the high rate of pregnancy termination.
Methods: We did a systematic literature review using Scopus, PubMed, and the Cochrane Library from inception through February 2020. Case series with >5 cases of isolated fetal ascites were eligible for inclusion. Cases of fetal ascites identified as part of fetal hydrops at presentation were excluded. Cases of isolated fetal ascites with genitourinary etiology were included in our analysis.
Results: 70 cases of isolated fetal ascites with genitourinary etiology were identified. This included posterior urethral valves (PUV) (20/70, 29%), Potter syndrome (3/70, 4.3%), vesicoureteral reflux (2/70, 2.9%), ureteropelvic junction obstruction (2/70, 2.9%), other genitourinary disorders (7/70, 10%) and in 36/70 cases (51%), the specific disorder was not reported. There were no cases of progression to fetal hydrops reported. Outcome data was available for 68/70 cases: 32/68 (47%) live births, 3/68 (4%) neonatal death, 5/68 (7%) intrauterine fetal demise and 28/68 (41%) had pregnancy termination.
Conclusion/Implications: A variety of genitourinary pathology can result in isolated fetal ascites with PUV being the most common. Neonatal survival is 80% amongst continuing pregnancies. Survival rate may be overestimated due to the high rate of pregnancy termination.
Introduction: Fetal ascites is defined as the presence of fluid within the fetal peritoneal cavity. Fetal ascites may occur alone as isolated fetal ascites or be diagnosed as part of fetal hydrops. Our objective was to identify the genitourinary causes of isolated fetal ascites and associated outcomes.
Methods: We did a systematic literature review using Scopus, PubMed, and the Cochrane Library from inception through February 2020. Case series with >5 cases of isolated fetal ascites were eligible for inclusion. Cases of fetal ascites identified as part of fetal hydrops at presentation were excluded. Cases of isolated fetal ascites with genitourinary etiology were included in our analysis.
Results: 70 cases of isolated fetal ascites with genitourinary etiology were identified. This included posterior urethral valves (PUV) (20/70, 29%), Potter syndrome (3/70, 4.3%), vesicoureteral reflux (2/70, 2.9%), ureteropelvic junction obstruction (2/70, 2.9%), other genitourinary disorders (7/70, 10%) and in 36/70 cases (51%), the specific disorder was not reported. There were no cases of progression to fetal hydrops reported. Outcome data was available for 68/70 cases: 32/68 (47%) live births, 3/68 (4%) neonatal death, 5/68 (7%) intrauterine fetal demise and 28/68 (41%) had pregnancy termination.
Conclusion/Implications: A variety of genitourinary pathology can result in isolated fetal ascites with PUV being the most common. Neonatal survival is 80% amongst continuing pregnancies. Survival rate may be overestimated due to the high rate of pregnancy termination.
Methods: We did a systematic literature review using Scopus, PubMed, and the Cochrane Library from inception through February 2020. Case series with >5 cases of isolated fetal ascites were eligible for inclusion. Cases of fetal ascites identified as part of fetal hydrops at presentation were excluded. Cases of isolated fetal ascites with genitourinary etiology were included in our analysis.
Results: 70 cases of isolated fetal ascites with genitourinary etiology were identified. This included posterior urethral valves (PUV) (20/70, 29%), Potter syndrome (3/70, 4.3%), vesicoureteral reflux (2/70, 2.9%), ureteropelvic junction obstruction (2/70, 2.9%), other genitourinary disorders (7/70, 10%) and in 36/70 cases (51%), the specific disorder was not reported. There were no cases of progression to fetal hydrops reported. Outcome data was available for 68/70 cases: 32/68 (47%) live births, 3/68 (4%) neonatal death, 5/68 (7%) intrauterine fetal demise and 28/68 (41%) had pregnancy termination.
Conclusion/Implications: A variety of genitourinary pathology can result in isolated fetal ascites with PUV being the most common. Neonatal survival is 80% amongst continuing pregnancies. Survival rate may be overestimated due to the high rate of pregnancy termination.
Genitourinary Etiologies of Isolated Fetal Ascites: A Systematic Review
Rebecca Horgan
Abstract
Discussion Forum (0)
Introduction: Fetal ascites is defined as the presence of fluid within the fetal peritoneal cavity. Fetal ascites may occur alone as isolated fetal ascites or be diagnosed as part of fetal hydrops. Our objective was to identify the genitourinary causes of isolated fetal ascites and associated outcomes.
Methods: We did a systematic literature review using Scopus, PubMed, and the Cochrane Library from inception through February 2020. Case series with >5 cases of isolated fetal ascites were eligible for inclusion. Cases of fetal ascites identified as part of fetal hydrops at presentation were excluded. Cases of isolated fetal ascites with genitourinary etiology were included in our analysis.
Results: 70 cases of isolated fetal ascites with genitourinary etiology were identified. This included posterior urethral valves (PUV) (20/70, 29%), Potter syndrome (3/70, 4.3%), vesicoureteral reflux (2/70, 2.9%), ureteropelvic junction obstruction (2/70, 2.9%), other genitourinary disorders (7/70, 10%) and in 36/70 cases (51%), the specific disorder was not reported. There were no cases of progression to fetal hydrops reported. Outcome data was available for 68/70 cases: 32/68 (47%) live births, 3/68 (4%) neonatal death, 5/68 (7%) intrauterine fetal demise and 28/68 (41%) had pregnancy termination.
Conclusion/Implications: A variety of genitourinary pathology can result in isolated fetal ascites with PUV being the most common. Neonatal survival is 80% amongst continuing pregnancies. Survival rate may be overestimated due to the high rate of pregnancy termination.
Methods: We did a systematic literature review using Scopus, PubMed, and the Cochrane Library from inception through February 2020. Case series with >5 cases of isolated fetal ascites were eligible for inclusion. Cases of fetal ascites identified as part of fetal hydrops at presentation were excluded. Cases of isolated fetal ascites with genitourinary etiology were included in our analysis.
Results: 70 cases of isolated fetal ascites with genitourinary etiology were identified. This included posterior urethral valves (PUV) (20/70, 29%), Potter syndrome (3/70, 4.3%), vesicoureteral reflux (2/70, 2.9%), ureteropelvic junction obstruction (2/70, 2.9%), other genitourinary disorders (7/70, 10%) and in 36/70 cases (51%), the specific disorder was not reported. There were no cases of progression to fetal hydrops reported. Outcome data was available for 68/70 cases: 32/68 (47%) live births, 3/68 (4%) neonatal death, 5/68 (7%) intrauterine fetal demise and 28/68 (41%) had pregnancy termination.
Conclusion/Implications: A variety of genitourinary pathology can result in isolated fetal ascites with PUV being the most common. Neonatal survival is 80% amongst continuing pregnancies. Survival rate may be overestimated due to the high rate of pregnancy termination.
Introduction: Fetal ascites is defined as the presence of fluid within the fetal peritoneal cavity. Fetal ascites may occur alone as isolated fetal ascites or be diagnosed as part of fetal hydrops. Our objective was to identify the genitourinary causes of isolated fetal ascites and associated outcomes.
Methods: We did a systematic literature review using Scopus, PubMed, and the Cochrane Library from inception through February 2020. Case series with >5 cases of isolated fetal ascites were eligible for inclusion. Cases of fetal ascites identified as part of fetal hydrops at presentation were excluded. Cases of isolated fetal ascites with genitourinary etiology were included in our analysis.
Results: 70 cases of isolated fetal ascites with genitourinary etiology were identified. This included posterior urethral valves (PUV) (20/70, 29%), Potter syndrome (3/70, 4.3%), vesicoureteral reflux (2/70, 2.9%), ureteropelvic junction obstruction (2/70, 2.9%), other genitourinary disorders (7/70, 10%) and in 36/70 cases (51%), the specific disorder was not reported. There were no cases of progression to fetal hydrops reported. Outcome data was available for 68/70 cases: 32/68 (47%) live births, 3/68 (4%) neonatal death, 5/68 (7%) intrauterine fetal demise and 28/68 (41%) had pregnancy termination.
Conclusion/Implications: A variety of genitourinary pathology can result in isolated fetal ascites with PUV being the most common. Neonatal survival is 80% amongst continuing pregnancies. Survival rate may be overestimated due to the high rate of pregnancy termination.
Methods: We did a systematic literature review using Scopus, PubMed, and the Cochrane Library from inception through February 2020. Case series with >5 cases of isolated fetal ascites were eligible for inclusion. Cases of fetal ascites identified as part of fetal hydrops at presentation were excluded. Cases of isolated fetal ascites with genitourinary etiology were included in our analysis.
Results: 70 cases of isolated fetal ascites with genitourinary etiology were identified. This included posterior urethral valves (PUV) (20/70, 29%), Potter syndrome (3/70, 4.3%), vesicoureteral reflux (2/70, 2.9%), ureteropelvic junction obstruction (2/70, 2.9%), other genitourinary disorders (7/70, 10%) and in 36/70 cases (51%), the specific disorder was not reported. There were no cases of progression to fetal hydrops reported. Outcome data was available for 68/70 cases: 32/68 (47%) live births, 3/68 (4%) neonatal death, 5/68 (7%) intrauterine fetal demise and 28/68 (41%) had pregnancy termination.
Conclusion/Implications: A variety of genitourinary pathology can result in isolated fetal ascites with PUV being the most common. Neonatal survival is 80% amongst continuing pregnancies. Survival rate may be overestimated due to the high rate of pregnancy termination.
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