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Case Reports
. 2017:2017:6760218.
doi: 10.1155/2017/6760218. Epub 2017 Oct 11.

Connatal Urinary Ascites in a Female Preterm

Barbara Brunner  1 , Elisabeth Ralser  1 , Elisabeth D'Costa  2 , Kathrin Maurer  3 , Ursula Kiechl-Kohlendorfer  1 , Elke Griesmaier  1
Affiliations
Case Reports

Connatal Urinary Ascites in a Female Preterm

Barbara Brunner et al. Case Rep Pediatr. 2017.

Abstract

Background: Connatal urinary ascites is rare in females without associated malformations and occurs following bladder rupture.

Case presentation: A female very preterm was delivered by caesarean section because of abnormal Doppler findings. The mother suffered from viral pneumonia requiring intensive care in the third trimester of pregnancy. Serial fetal ultrasound examinations showed a megacystis and ascites. Postnatally, pronounced isolated ascites was drained and its urinary nature was confirmed. The bladder leak was demonstrated when blue dye, instilled via a Foley catheter, appeared in the ascitic drain. After removal of the catheter spontaneous micturition was unremarkable. A micturating cystourethrogram showed spontaneous closure of the bladder leak.

Conclusion: The female infant experienced fetal bladder rupture and connatal urinary ascites due to maternal pneumonia and intensive care. The use of blue dye is an effective alternative method to any contrast media radiography and should be considered, especially in very preterm infants.

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Figures

Figure 1
Figure 1
Abdominal ultrasound images showing massive ascites. (a) Transverse section through the epigastrium. (b) Longitudinal section through the left kidney that appears normal in shape and length. (c) Longitudinal section through the liver and lung (li: liver; lu: lung) showing no pleural effusion. (d) Longitudinal section through the bladder (b: bladder; u: uterus; sa: sacrum; s: symphysis), which is almost empty.
Figure 2
Figure 2
Infant in supine position, ascitic drain in the right abdomen filled with blue dye.
See this image and copyright information in PMC

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