Fetal ascites associated with ABO incompatibility: Case report and review of the literature,☆☆,

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Abstract

We report a pregnancy complicated by anti-B isoimmunization that resulted in fetal ascites, anemia, hepatomegaly, and polyhydramnios. A previous pregnancy in the same patient was complicated by neonatal ABO incompatibility. A review of the obstetric literature suggests that ABO incompatibility may cause severe fetal anemia, especially in patients with type O blood or a previous history of ABO incompatibility of the newborn. (Am J Obstet Gynecol 1996;175:1371-2.)

Section snippets

CASE REPORT

The patient, a 32-year-old woman (gravida 2, para 1-0-0-1), had type O, Rh-positive blood. She was referred to our High-Risk Pregnancy Unit at 35 weeks' gestation with spontaneous rupture of membranes. The pregnancy had been uncomplicated until 2 days before admission, when fundal size appeared greater than expected and an ultrasonographic examination revealed fetal ascites and polyhydramnios. Results of a previous ultrasonographic examination performed at 23 weeks' gestation had been reported

COMMENT

ABO incompatibility is a common hematologic problem in newborns. Approximately 20% to 25% of pregnancies are at risk for ABO incompatibility, with mothers having anti-A or anti-B antibodies and their infants having the respective antigens. Newborns with the disease may have no symptoms or may have symptoms of hyperbilirubinemia, anemia, or cholestasis. Mild ABO incompatibility occurs in approximately 1 of 150 births, and severe disease is seen in approximately 1 of 3000 births.

ABO

References (3)

  • DM Sherer et al.

    Severe fetal hydrops resulting from ABO incompatibility

    Am J Obstet Gynecol

    (1991)
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From the Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology,a and the Section of Neonatology, Department of Pediatrics,b Bridgeport Hospital.

☆☆

Reprint requests: Robert J. Stiller, MD, Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610.

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