Clinical Significance of Hyperechogenic Bowel in Second-Trimester Ultrasound Scan

Document Type : Original Article

Authors

1 Clinical Research Development Center, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 King’s College Hospital and Fetal Medicine Foundation, London, England National Association of Gynecologists and Obstetricians, Private Fetal Medicine Practice, Tehran, Iran& Director of International Affairs of National Association of Gynecologists

Abstract

Background: This study aimed to report the incidence of bowel obstruction, chromosomal abnormality, congenital infection, fetal growth restriction (FGR), and otheranomalies in fetuses with hyperechogenic bowel (HEB) diagnosed during the second-trimester fetal ultrasound scan.
Methods: In total, 350 fetuses with a diagnosis of HEB in our maternal-fetal medicine referral center were evaluated with a detailed fetal ultrasound examination by an experienced perinatologist. If no associated anomalies were observed, women were counseled about the risk of potential fetal disorders and offered appropriate testing, including detailed fetal sonography, karyotype, maternal cytomegalovirus (CMV), and toxoplasmosis serology,as well as serial fetal biometry and bowel diameter follow up.
Results: Altogether there were 18(5.1%) fetuses with associated problems, including major anomalies, chromosomal abnormalities, and CMV infection. Moreover, 32(9.1%) fetuses developed FGR during follow-up.
Conclusion: An overall rate of adverse conditions of 14.2% with prenatally detected HEB serves to inform obstetricians and emphasizes the importance of careful screening fetal ultrasound studies and timely referral for an additional assessment about associated findings.It should be noted that isolated HEB has good outcomes.

Keywords

References

1. Al-Kouatly HB, Chasen ST, Streltzoff J, Chervenak FA. The clinical significance of fetal echogenic bowel. AmJObstetGynecol. 2001;185(5):1035-8.
2. Findley R, Allen VM, Brock JA. Adverse perinatal conditions associated with prenatally detected fetal echogenic bowel in nova scotia. JObstetGynaecol Can. 2018;40(5):555-60.
3. Masini G, Maggio L, Marchi L, Cavalli I, Ledda C, Trotta M, et al. Isolated fetal echogenic bowel in a retrospective cohort: the role of infection screening. Eur JObstetGynecolReprod Biol. 2018;231:136-41.
4. D'Amico A, Buca D, Rizzo G, Khalil A, Silvi C, Makatsariya A, et al. Outcome of fetal echogenic bowel: a systematic review and meta‐analysis. PrenatDiagn. 2020; In Press.
5. Bromley B, Doubilet P, Frigoletto FD Jr, Krauss C, Estroff JA, Benacerraf BR. Is fetal hyperechoic bowel on second-trimester sonogram an indication for amniocentesis? ObstetGynecol. 1994;83(5 Pt 1): 647-51.
6. Sepulveda W, Reid R, Nicolaidis P, Prendiville O, Chapman RS, Fisk NM. Second-trimester echogenic bowel and intraamniotic bleeding: association between fetal bowel echogenicity and amniotic fluid spectrophotometry at 410 nm. AmJObstetGynecol. 1996;174(3):839-42.
7. Ronin C, Mace P, Stenard F, Loundou A, Capelle M, Mortier I, et al. Antenatal prognostic factor of fetal echogenic bowel. Eur JObstetGynecol Reprod Biol.
Laird A, Shekleton P, Nataraja RM, Kimber C, Pacilli M. Incidence of gastro‐intestinal anomalies and surgical outcome of fetuses diagnosed with echogenic bowel and bowel dilatation. PrenatDiagn. 2019;39(12):1115-9.
9. Yinon Y, Farine D, Yudin MH, Gagnon R, Hudon L, Basso M, et al. Cytomegalovirus infection in pregnancy. JObstetGynaecol Can. 2010;32(4): 348-54.
10. Bessieres MH, Berrebi A, Cassaing S, Fillaux J, Cambus JP, Berry A, et al. Diagnosis of congenital toxoplasmosis: prenatal and neonatal evaluation of methods used in Toulouse University Hospital and incidence of congenital toxoplasmosis. MemInst Oswaldo Cruz. 2009;104(2):389-92.
11. Royal College of Obstetricians &Gynaecologists. Small-for-gestational-age fetus, investigation and management. London: Royal College of Obstetricians and Gynecologists; 2014.
12. Nyberg DA, Mack LA, Patten RM, Cyr DR. Fetal bowel. Normal sonographic findings. JUltrasound
Med. 1987;6(1):3-6.
13. Gordijn SJ, Beune IM, Thilaganathan B, Papageorghiou A, Baschat AA, Baker PN, et al. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound ObstetGynecol. 2016; 48(3):333-9.
14. Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements--a prospective study. AmJObstetGynecol. 1985;151(3):333-7.
15. Sal H, Comert EH, Ekici YS, Aran T. Perinatal outcome of fetal echogenic bowel: a single-center retrospective cohort study. GynecolObstetReprod Med. 2019; 25:1-5.
16. Hurt L, Wright M, Dunstan F, Thomas S, Brook F, Morris S, et al. Prevalence of defined ultrasound findings of unknown significance at the second trimester fetal anomaly scan and their association with adverse pregnancy outcomes: the Welsh study of mothers and babies population‐based cohort. PrenatDiagn. 2016;36(1):40-8.
Iranian Journal of Neonatology
Volume 11, Issue 4
October 2020
Pages 69-73

Files

Share

How to cite

Statistics