Case report reveals severe congenital cytomegalovirus presenting with massive ascites and oligohydramnios in a fetus, highlighting diagnostic overlap with urinary anomalies.
A woman, gravida 5, para 3, presented with fetal ascites at 19 weeks of gestation. Urinary ascites was initially suspected because of massive ascites and oligohydramnios; however, biochemical analysis of fetal ascites was inconsistent with this diagnosis. A peritoneal-amniotic shunt was placed to prevent pulmonary hypoplasia. Postoperative bladder filling ruled out urinary ascites. At 28 weeks, findings suggestive of congenital cytomegalovirus (cCMV) infection emerged. The fetus was delivered at 29 weeks of age due to fetal distress and was diagnosed with cCMV by PCR. The neonate died 7 days after the gastrointestinal perforation.
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Masui et al. (2025) studied this question.
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