Fetal ascites and second trimester maternal hepatitis C virus infection.
OBJECTIVE
To present the first reported case of early second trimester maternal hepatitis C virus (HCV) associated with fetal ascites, which was treated with fetal paracentesis, and resulted in a successful outcome of a term liveborn infant with anti-HCV seropositivity.


METHODS
A 26-year-old primigravida woman was diagnosed with acute HCV infection at 17 weeks of gestation. Ultrasound (US) at 23 weeks showed significant fetal as cites and echogenic bowel, and fetal viral infection was suspected. Maternal serum was positive for high HCV-RNA titers and cytomegalovirus (CMV) IgG. Amniocentesis, cordocentesis and therapeutic fetal paracentesis were performed at 23 weeks. Fetal karyotype was 46, XX. Cord blood showed anti-HCV positivity and HCV-RNA titer < 10. Amniotic fluid was anti-HCV and CMV IgG positive. US at 27 weeks showed complete resolution of fetal ascites. A healthy 2,976 g female baby was delivered at 37 weeks, with anti-HCV seropositivity, high HCV-RNA titers, CMV IgG positive, IgM negative and normal liver function tests at the 1-month follow-up.


CONCLUSIONS
Second trimester perinatal HCV infection with possible CMV coinfection associated with fetal ascites is a rare event. Fetal therapy resulting in a successful outcome has not been reported. Prompt fetal therapy with paracentesis in this case led to the delivery of a healthy term liveborn baby with anti-HCV seropositivity.
Ling
Pei-Ying
PY
Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei. peiyingling@yahoo.com.tw
Fang
Shiuh-Bin
SB
Liao
Wen-Chien
WC
Lu
Yen-Mong
YM
Jou
Hei-Jen
HJ
D000208:Acute Disease; D000328:Adult; D000653:Amniotic Fluid / Q000821:virology; D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology*; D015897:Comorbidity; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D019152:Paracentesis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012367:RNA, Viral / Q000032:analysis; D016216:Ultrasonography, Prenatal
D012367:RNA, Viral