Nonvisualization of the fetal gallbladder: frequency and prognostic importance.

Hertzberg, Barbara S.; Kliewer, Mark A.; Maynor, Carolyn H.; McNally, Patricia; Bowie, J D; Kay, Helen H.; Hage, Marvin L.; Livingston, Elizabeth

doi:10.1148/radiology.199.3.8637986

Cited by 38 publications

(39 citation statements)

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“…Nonvisualization of the fetal gallbladder is rare and occurs in 0.1% to 0.15% of pregnancies (Bronshtein et al, 1993;Blazer et al, 2002), Hertzberg et al (1996) reported a frequency of 7.1%, which may be explained by the small number of patients included between 20 and 24 weeks of gestation (n = 84).…”

Section: Discussionmentioning

confidence: 99%

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Nonvisualization of the fetal gallbladder by second‐trimester ultrasound scan: strategy of clinical management based on four examples

et al. 2008

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Objective When the fetal gallbladder is not seen at ultrasound (US) scan, to propose a diagnostic method of differentiating fetuses who are healthy or have minor anomalies from fetuses with severe anomalies requiring intensive management. MethodWe present four clinical cases illustrating this variability, together with additional examinations: karyotyping, screening for cystic fibrosis mutations, amniotic fluid digestive enzyme activities. ResultsThe four examples we present-biliary duct atresia, biliary agenesis, gallbladder reveal at birth, and cystic fibrosis-illustrate the difficulties of making both diagnosis and prognosis prenatally when the gallbladder is not visualized. Laboratory assays allowed prenatal management. ConclusionFailure to visualize the gallbladder prenatally may indicate fetal diseases of highly variable prognosis, but may also sometimes be followed by postnatal visualization in a child free of any disease. Prenatal management could help in defining diagnosis and prognosis.

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Section: Discussionmentioning

confidence: 99%

“…In such cases, a gallbladder undetected prenatally is sometimes visualized postnatally in a disease-free child (Hertzberg et al, 1996;Blazer et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Nonvisualization of the fetal gallbladder by second‐trimester ultrasound scan: strategy of clinical management based on four examples

et al. 2008

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“…The feasibility of visualization of the fetal gallbladder by ultrasound in the early second trimester is well established [1,2,3]. The hypoechoic elliptic structure with echogenic borders, located in the right upper abdomen, can already be observed by transvaginal ultrasound at 14-16 weeks of gestation in 99.9% of pregnancies [1,2].…”

Section: Introductionmentioning

confidence: 99%

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Bardin¹,

Ashwal‏²,

Davidov³

et al. 2015

Fetal Diagn Ther

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Objective: In cases of nonvisualization of the fetal gallbladder (NVFGB), we investigated whether amniotic fluid levels of γ-glutamyl transpeptidase (GGTP) can distinguish normal development or benign gallbladder agenesis from severe anomaly such as biliary atresia. Methods: This is a retrospective cohort study of pregnancies in which the gallbladder was not visualized in the second-trimester fetal anatomy scan. Levels of GGTP in amniotic fluid were analyzed prior to 22 weeks of gestation by amniocentesis. Data were collected regarding other fetal malformations, fetal karyotype, and screening results for cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations. Results: Of 32 cases of NVFGB, 27 (84%) had normal GGTP levels and a normal CFTR gene screening, and 1 of them had an abnormal karyotype. Three of the 5 cases with low GGTP were diagnosed with extrahepatic biliary atresia, proven by histopathological examination following termination of pregnancy. The fourth case had hepatic vasculature abnormality and the fifth isolated gallbladder agenesis. In 22 of 32 cases (68.7%), the gallbladder was detected either later in pregnancy or after delivery. Conclusion: The findings support low levels of GGTP in amniotic fluid, combined with NVFGB, as a sign of severe disease, mainly biliary atresia. Normal GGTP levels, concomitant with isolated NVFGB, carry a good prognosis.

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“…Antenatal sonography depicts the normal fetal gallbladder as an ovoid or teardrop-shaped structure in the right midabdomen, extending peripherally toward the anterolateral abdominal wall. [13][14][15] The anatomy surrounding the foci should be scrutinized for the gallbladder wall interface or a crescent of hypoechoic bile. Just as in the adult, this pattern in the appropriate location establishes the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Fetal gallstones in a contracted gallbladder: potential to simulate hepatic or peritoneal calcification.

Hertzberg

Kliewer

1998

Journal of Ultrasound in Medicine

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Nonvisualization of the fetal gallbladder: frequency and prognostic importance.

Abstract: Most fetuses with nonvisualization of the gallbladder have normal outcomes. The rate of nonvisualization of the fetal gallbladder is sufficiently high to undermine the utility of gallbladder visualization as a screen for fetal abnormality.

Cited by 38 publications

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Nonvisualization of the fetal gallbladder by second‐trimester ultrasound scan: strategy of clinical management based on four examples

Nonvisualization of the fetal gallbladder by second‐trimester ultrasound scan: strategy of clinical management based on four examples

Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ

Fetal gallstones in a contracted gallbladder: potential to simulate hepatic or peritoneal calcification.

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Nonvisualization of the fetal gallbladder: frequency and prognostic importance.

Abstract: Most fetuses with nonvisualization of the gallbladder have normal outcomes. The rate of nonvisualization of the fetal gallbladder is sufficiently high to undermine the utility of gallbladder visualization as a screen for fetal abnormality.

Cited by 38 publications

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Nonvisualization of the fetal gallbladder by second‐trimester ultrasound scan: strategy of clinical management based on four examples

Nonvisualization of the fetal gallbladder by second‐trimester ultrasound scan: strategy of clinical management based on four examples

Nonvisualization of the Fetal Gallbladder: Can Levels of &#947;-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosis&#947;

Fetal gallstones in a contracted gallbladder: potential to simulate hepatic or peritoneal calcification.

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Nonvisualization of the Fetal Gallbladder: Can Levels of γ-Glutamyl Transpeptidase in Amniotic Fluid Predict Fetal Prognosisγ