Echogenic fetal bowel during the second trimester: clinical importance.

Abstract

Clinical outcomes of 95 second-trimester fetuses prospectively considered to have echogenic bowel at ultrasound were compared with a control group of 110 consecutive second-trimester fetuses. Among the 95 fetuses in the study group, 64 (67%) had moderately echogenic (grade 2) or markedly echogenic (grade 3) bowel relative to the liver. Among the 110 fetuses in the control group, only two (1.8%) had moderately echogenic (grade 2) bowel; the rest (98.2%) had isoechoic (grade 0) or midly echogenic (grade 1) bowel relative to the liver. Adverse outcomes occurred in 45 of the 95 fetuses (47%) with echogenic bowel compared with eight of the 110 fetuses (7.27%) in the control group (P < .01; relative risk, 6.5; 95% confidence interval, 3.2, 13.1). Adverse outcomes included chromosomal abnormalities, intrauterine growth retardation, fetal demise, or other fetal anomalies. Within the study group, adverse outcomes occurred in 40 of the 64 fetuses (62%) with grade 2 or 3 bowel echogenicity, compared with five of the 31 fetuses (16%) with grade 1 echogenicity. Echogenic bowel is associated with an increased risk of adverse fetal outcome and this risk is confined primarily to grades 2 and 3 echogenicity.

Sonographic markers of fetal trisomies: second trimester.

“…8). [74][75][76][77][78] Hyperechoic bowel has also been reported in association with bowel atresia, congenital infection, and, rarely, meconium ileus secondary to cystic fibrosis. 79,80 An increased risk of IUGR, fetal death, and placenta-related complications is also recognized as being associated with hyperechoic bowel.…”

Fetal Abdominal Anomaliler

“…Etyolojisinde anöploidi, amnion sıvısı içine kanama, konjenital enfeksiyonlar, kistik fibrozis ve gastrointestinal atreziler gibi çok sayıda neden bulunmaktadır [24][25][26]. Ayrıca izole ekojenik barsak saptanan fetüslerde intrauterin gelişme geriliği ve intrauterin fetal ölüm insidansında artış vardır [26][27][28]. …”

Hyperechogenic fetal bowel.

“…8 Other rarer associations with hyperechogenic fetal bowel have been reported: mechanical intestinal obstruction due to imperforate anus, intestinal atresia, or volvulus2 1920; congenital cytomegalovirus infection' 5 Stinger, Thornton, Mason may in fact be misleading and false positive results have been reported.27 When combined with bowel dilatation, the finding is probably much more suggestive of meconium ileus.2 3 28 Given this spectrum of associated pathologies, it is not surprising that perinatal death is linked to hyperechogenic bowel in the fetus. The risk of an adverse fetal outcome seems to be greater the more echogenic the bowel and is highest when the density is comparable with bone.5 6 14…”