Background: Hepatitis A is a common, self-limited disease transmitted
by fecal-oral contamination. Case: A 23-year-old woman, para 2-0-0-2,
developed hepatitis A at 20 weeks' gestation. At 27 weeks, ultrasound
revealed polyhydramnios and fetal ascites. Hepatitis A immunoglobulin
M antibody in fetal blood obtained by funipuncture confirmed acute hep
atitis A infection in the fetus. Polyhydramnios and ascites persisted
until 35 weeks, when the fetus developed ultrasound signs of meconium
peritonitis, and delivery was accomplished uneventfully. Meconium peri
tonitis was diagnosed in the neonatal period and treated surgically. C
onclusion: To our knowledge, this is the first report of intrauterine
transmission of hepatitis A. The disease presented with fetal ascites
and was confirmed by positive fetal blood serology.