Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal Ascites
Background: Perinatal Hepatitis C Virus (HCV) transmission occurs in 4–7% of the cases with detectable viremia at delivery. HCV testing in pregnancy is recommended. The fetal infection was previously described as asymptomatic although there are two cases, including this one, to report the presence o...
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MDPI AG
2022-11-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/11/11/1335 |
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| author | Cristiana Luiza Rădoi Elena-Iuliana-Anamaria Berbecaru Anca-Maria Istrate-Ofițeru Rodica Daniela Nagy Roxana Cristina Drăgușin Razvan Grigoraș Căpitănescu Marian Valentin Zorilă Lucian George Zorilă Dominic Gabriel Iliescu |
| author_facet | Cristiana Luiza Rădoi Elena-Iuliana-Anamaria Berbecaru Anca-Maria Istrate-Ofițeru Rodica Daniela Nagy Roxana Cristina Drăgușin Razvan Grigoraș Căpitănescu Marian Valentin Zorilă Lucian George Zorilă Dominic Gabriel Iliescu |
| author_sort | Cristiana Luiza Rădoi |
| collection | DOAJ |
| description | Background: Perinatal Hepatitis C Virus (HCV) transmission occurs in 4–7% of the cases with detectable viremia at delivery. HCV testing in pregnancy is recommended. The fetal infection was previously described as asymptomatic although there are two cases, including this one, to report the presence of isolated fetal ascites in HCV infected fetuses. Case report: A 42-year-old patient, 3G, 3P, presented in the Emergency Room for painful uterine contraction. The third-trimester ultrasound examination noted severe fetal ascites, accompanied by hyperechoic bowels and polyhydramnios. The diagnosis required a detailed ultrasound exam, invasive testing (amniocentesis, cordocentesis, and fetal paracentesis), and a complete workup. The mother tested positive for HCV antibodies, and the fetal cord blood tested positive for HCV RNA. The ascites resolved after paracentesis, and the gastrointestinal and respiratory functions markedly improved. The fetus was delivered at term in good condition. Conclusions: The etiology of isolated fetal ascites is broad. This case may indicate that intrauterine HCV transmission is a potential cause of isolated fetal ascites in the absence of other explanation, and isolated fetal ascites can be the only sign revealed on a routine examination. We suspected, having no other detected cause for ascites, the intrauterine transmission of HCV. Invasive procedures, such as paracentesis, are required for abdominal decompression to manage isolated fetal ascites, as it may be a saving procedure. A genetic investigation is needed, and a good neonatal outcome is expected in the absence of fetal structural or genetic abnormalities, as in our case. |
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| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-09T18:05:05Z |
| publishDate | 2022-11-01 |
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| series | Pathogens |
| spelling | doaj.art-31cd7e21d54b49c6a4dd8ee6dc5de6002023-11-24T09:34:03ZengMDPI AGPathogens2076-08172022-11-011111133510.3390/pathogens11111335Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal AscitesCristiana Luiza Rădoi0Elena-Iuliana-Anamaria Berbecaru1Anca-Maria Istrate-Ofițeru2Rodica Daniela Nagy3Roxana Cristina Drăgușin4Razvan Grigoraș Căpitănescu5Marian Valentin Zorilă6Lucian George Zorilă7Dominic Gabriel Iliescu8Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, RomaniaDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, RomaniaDepartment of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, RomaniaDepartment of Forensic Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, RomaniaDepartment of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, RomaniaBackground: Perinatal Hepatitis C Virus (HCV) transmission occurs in 4–7% of the cases with detectable viremia at delivery. HCV testing in pregnancy is recommended. The fetal infection was previously described as asymptomatic although there are two cases, including this one, to report the presence of isolated fetal ascites in HCV infected fetuses. Case report: A 42-year-old patient, 3G, 3P, presented in the Emergency Room for painful uterine contraction. The third-trimester ultrasound examination noted severe fetal ascites, accompanied by hyperechoic bowels and polyhydramnios. The diagnosis required a detailed ultrasound exam, invasive testing (amniocentesis, cordocentesis, and fetal paracentesis), and a complete workup. The mother tested positive for HCV antibodies, and the fetal cord blood tested positive for HCV RNA. The ascites resolved after paracentesis, and the gastrointestinal and respiratory functions markedly improved. The fetus was delivered at term in good condition. Conclusions: The etiology of isolated fetal ascites is broad. This case may indicate that intrauterine HCV transmission is a potential cause of isolated fetal ascites in the absence of other explanation, and isolated fetal ascites can be the only sign revealed on a routine examination. We suspected, having no other detected cause for ascites, the intrauterine transmission of HCV. Invasive procedures, such as paracentesis, are required for abdominal decompression to manage isolated fetal ascites, as it may be a saving procedure. A genetic investigation is needed, and a good neonatal outcome is expected in the absence of fetal structural or genetic abnormalities, as in our case.https://www.mdpi.com/2076-0817/11/11/1335fetal infectionsfetal ascitescongenital hepatitisprenatal diagnosisultrasoundamniocentesis |
| spellingShingle | Cristiana Luiza Rădoi Elena-Iuliana-Anamaria Berbecaru Anca-Maria Istrate-Ofițeru Rodica Daniela Nagy Roxana Cristina Drăgușin Razvan Grigoraș Căpitănescu Marian Valentin Zorilă Lucian George Zorilă Dominic Gabriel Iliescu Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal Ascites Pathogens fetal infections fetal ascites congenital hepatitis prenatal diagnosis ultrasound amniocentesis |
| title | Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal Ascites |
| title_full | Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal Ascites |
| title_fullStr | Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal Ascites |
| title_full_unstemmed | Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal Ascites |
| title_short | Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal Ascites |
| title_sort | intrauterine transmission of hepatitis c virus concomitant with isolated severe fetal ascites |
| topic | fetal infections fetal ascites congenital hepatitis prenatal diagnosis ultrasound amniocentesis |
| url | https://www.mdpi.com/2076-0817/11/11/1335 |
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