Spontaneous intrauterine remission of fetal ascites in one identical twin: Report of a case with ultrasound evaluation

BACKGROUND: Fetal ascites is usually a precursor of, or one of the findings in, hydrops fetalis. The spontaneous intrauterine remission of fetal ascites, especially in twin pregnancy, is extremely low. CASE: A woman had sonographically documented fetal ascites in one identical twin. The workup for immunologic or nonimmunologic causes was negative except for the absence of end diastolic flow in the umbilical artery, demonstrated by Doppler ultrasonography in the affected fetus. Subsequent sonographic examinations demonstrated disappearance of the ascites as resistance of the umbilical artery progressively improved. CONCLUSION: In evaluating the hemodynamic changes in this condition, Doppler ultrasonography can elucidate the pathophysiology of fetal ascites formation in a monochorionic twin and also provide information for guiding management.