Ascites in a case of severe preeclampsia with twin gestation

Abstract

We report a rare case of massive maternal ascites complicating severe preeclampsia in a case of twin gestation. This complication developed in association with severe hypertension and marked proteinuria. Ascites has been reported at cesarean section delivery in pregnancies complicated by preeclampsia. Hypoproteinemia caused by the excretion of large amounts of protein in the urine seems to be a partial etiological factor aggravated by the renal retention of sodium and water. The onset of massive ascites causes respiratory compromise in all the patients. Careful antenatal assessment and informed anticipation may help in detecting more cases with this complication, which is often missed and thereby help in reducing both maternal and perinatal morbidity and mortality. The purpose of this report is to increase the awareness of such nonclassical and atypical features of preeclampsia.