Voluminous Fetal Chylous Ascites: A Case of Complete Spontaneous Prenatal Regression

Abstract

We report a case of isolated voluminous fetal ascites discovered during a routine fetal ultrasound at 22 weeks’ gestation. Analysis of the fluid showed it to be chyliform and ruled out other causes of fetal ascites. Regular bimonthly ultrasound scans monitored its progressive diminution and then its disappearance. Examination showed the child to be normal at birth. Though the literature indicates that prognosis is usually favorable for infants with isolated fetal chylous ascites, spontaneous regression during pregnancy is an uncommon finding.

Hypoplasia of abdominal wall muscles following massive fetal persistent chylous ascites without anemia

“…Congenital chylothorax and chylous ascites could occur during fetal life due to lymph leakage into the pleural and/or peritoneal cavities, and their causes include inappropriate chyle transport toward the main circulation because of aplasia, hypoplasia, obstruction or thoracic duct severance; they are idiopathic in numerous cases [ 5 ]. Moreover, spontaneous regression of primary fetal hydrothorax commonly occurs in 9–22% of cases [ 6 ], whereas only one report described a case of fetal chylous ascites that spontaneously regressed before birth [ 7 ]. In this case, cytological examination of the fetal peritoneal fluid revealed chylous ascites.…”

Preoperative administration of Sudan III and successful treatment of persistent chylous ascites in a neonate

“…However, Favre and coworkers [5] found only three cases among 79 instances of fetal ascites, and an exhaustive literature review identified only 17 cases of prenatally detected chylous ascites from 1979 to 2004 [6]. The diagnosis of the chylous nature of the ascites is based on cytologic and biologic analysis of the fluid, excluding systematically other causes of fetal ascites (eg, karyotyping disorders, metabolic disease, infections, etc).…”

Suspected idiopathic intestinal lymphangiectasia in two foals with chylous peritoneal effusion

“…Abdominocentesis and fluid analysis are the confirmatory diagnostic tools. Based on human literature, the prognosis is generally good when it is an isolated disorder (Chereau et al. 2007).…”