title: Ascites, anemia and (intestinal) atresia.
abstract: We report a neonate who presented antenatally with fetal ascites and fetal anemia. The cause of this remained uncertain until 2 weeks later when bowel dilatation was noted on antenatal ultrasound. Clinical signs of intestinal obstruction became evident after delivery, and ileal atresia was found at laparotomy, which was resected with primary anastomosis. Recent reports in the literature have suggested a possible connection between fetal ascites, anemia and dilated bowel with neonatal intestinal obstruction. In these cases and ours, the likely sequence of events was that of in utero midgut volvulus with bleeding into ischemic bowel, hemorrhagic ascites resulting in fetal anemia and progressive bowel dilatation occurring as a consequence of intestinal atresia. Early treatment in our patient with intrauterine blood transfusion may have altered the natural history of her condition, allowing pregnancy to progress to term with a subsequent improved outcome.
authors.affiliation: Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore.
authors.forename: R M R
authors.initials: RM
authors.lastname: Tan
authors.affiliation: Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore.
authors.forename: J
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, National University Hospital, Singapore.
authors.forename: A
authors.initials: A
authors.lastname: Biswas
authors.affiliation: Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore.
authors.forename: C
authors.initials: C
authors.lastname: Amutha
mesh_terms: D000740:Anemia / Q000209:etiology*; D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000150:complications / Q000175:diagnosis*; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology; D045822:Intestinal Volvulus / Q000150:complications; D007421:Intestine, Small / Q000002:abnormalities*; D011859:Radiography; D016216:Ultrasonography, Prenatal