Characterization of Ascites Present at Cesarean Section

Abstract

Ascites has been reported at cesarean section delivery in pregnancies complicated by preeclampsia. The frequency and composition of peritoneal fluid collections in pregnancy have not previously been described. This descriptive study evaluated presence, composition, and characteristics of ascites present in 41 women undergoing cesarean delivery for a variety of indications. Twenty-six women had sufficient quantities of peritoneal fluid to be collected immediately after opening the parietal peritoneum. The protein content of the fluid was analyzed. The presence of fluid was not related to labor preceding delivery. All preeclamptic women in this study had fluid obtainable at cesarean section. Large volume ascites was noted in five preeclamptic women whose fluid had low total protein content, consistent with a transudate. Intrahepatic portal hypertension is one possible explanation of the large volume and low protein ascites in some preeclamptic patients. Ultrasonic measurements in preeclamptic patients and normotensive pregnant women showed uniform portal vein diameters and Doppler-derived portal vein flow velocities in all patients. The physiology of peritoneal fluid production in complicated and normal pregnancy remains unexplained.

Massive ascites in severe pre‐eclampsia: A rare complication

“…Pre‐eclamptic toxemia (PET) is primarily a vascular endothelial disorder triggered by the human placenta. Some amount of peritoneal fluid is frequently seen during cesarean section of normal 1 and hypertensive gravid women, 2 but massive ascites, such as the presence of 2 L or more of ascitic fluid, is a rare finding in PET patients.…”

Massive ascites following spontaneous vaginal delivery in a woman with preeclampsia-a diagnostic and management challenges in a low resource country: A case report

“…The basic patho-physiology involves the release of vasoconstrictive agents, endothelial damage, hyperpermeability of the capillaries and microangiopathic hemolysis [ 3 , 6 ]. Ascites is reported antenatally, after normal delivery and after cesarean section in the postpartum period, as well as during cesarean section in women with preeclampsia [ [4] , [5] , [6] , 8 , 9 ]. There are case reports of postpartum ascites caused by bladder rupture following vaginal delivery [ 10 ], tuberculosis peritonitis [ 11 ], idiopathic chylous ascites [ 12 ], pregnancy specific liver disease [ 13 ], lupus peritonitis [ 14 ], etc.…”

Disfagia secundaria a ascitis en preeclampsia con criterios de severidad

“…La asociación y posible causalidad entre preeclampsia y ascitis está bien establecida 9,12,15,20 e incluso existen estudios epidemiológicos de su prevalencia en población mexicana. 16 La presencia de ascitis masiva secundaria a preeclampsia es mucho menos frecuente, pero también cuenta con varios casos reportados en la literatura.…”