A 16-year-old primigravida was referred to our department at 22 weeks gesta
tion because of a nonimmune hydrops fetalis. Sonography revealed an isolate
d fetal ascites. Cordocentesis was performed to rule out anaemia, infection
and chromosomale abnormalities, followed subsequently by intrauterine tran
sfusion because of fetal anaemia (hemoglobin-concentration of 8.4 g/dl).
It was found that the pregnant suffered from an acute hepatitis-B-virus-inf
ection with positive HBsAg, positive HBeAg and HBc-IgM antibodies, confirme
d by serological tests.
In a second cordocentesis the cordblood specimen was found to be HBsAg posi
tive as well. The fetus was intramusculary given hyperimmune-globulin under
In the further course of pregnancy signs of meconium-peritonitis were obser
ved. Postnatally a distal ilcal perforation was detected and the newborn un
derwent laparotomy for distal ileal perforation. In this case report we dis
cuss the connection with nonimmune hydrops fetalis and the maternal and fet