Maternal Ascites as an Atypical Presentation of Severe Preeclampsia: A Case Report.

Am J Case RepNov 4, 2026 (epub)
Case ReportObstetrics & Gynecology

Kylie Rayburn, Jesse Cottrell, Amanda Pauley

✦ AI-curated · Sources linked

Case in brief

A 23-year-old woman at 30 weeks and 2 days’ gestation, admitted with fetal growth restriction and intermittent absent end-diastolic flow on umbilical artery Doppler, developed severe preeclampsia superimposed on chronic hypertension. She had profound capillary leak with marked third spacing, including 1.8 L of ascites and pleural effusions. Recognizing the fluid accumulation as part of severe preeclampsia informed management and assessment of maternal and fetal risk, including the need for delivery. The report emphasizes that this presentation can complicate clinical evaluation.

What made this case unusual

The severe preeclampsia was accompanied by profound capillary leak, large-volume ascites, and pleural effusions—an uncommon pattern of third spacing in this setting.

Diagnostic / clinical pearl

In a patient with severe hypertensive disease of pregnancy, unexplained ascites or other marked fluid accumulation may reflect preeclampsia-associated capillary leak and should be considered in assessing disease severity.

Source

PubMed · PMID 42978206

Published in Am J Case Rep. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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