Objective
To investigate perinatal outcomes of fetal echogenic bowel (FEB).
Methods
This is a retrospective observational study of FEB cases referred between January 2005 and December 2010. Data was obtained from Fetal Medicine, Obstetric, Neonatal Databases.
Results
There were 139 cases, mean gestation 21+5 (15+1–35+5) weeks. 53 (38%) had fetal karyotyping. Of the six abnormal results, all had other structural anomalies.
66 (47%) were screened for toxoplasma and cytomegalovirus. The two cases of confirmed fetal cytomegalovirus infection both had additional ultrasound markers. One had termination of pregnancy (TOP), the other developed fetal hydrops at 33 weeks.
44 couples were screened for cystic fibrosis, 2 had carrier status but partners screened negative.
Uterine Artery Doppler (UAD) screening was performed in 120 women. Of the 99 (82.5%) who screened negative (Mean PI <1.45), there were no cases of pre-eclampsia, 3 had fetal growth restriction (FGR) at term (birth weight <5th centile). Of the 21 (17.5%) who screened positive (mean PI ≤1.45), six had intrauterine deaths (25–31 weeks) from placental abruption ± FGR, one TOP for severe FGR (23 weeks), two lost to follow-up and four live births >36 weeks.
Overall, there were 106 live births, 16 (15%) preterm, 26 (24.5%) required special care for 15 (1–78) days, 102 established enteral feeds, none had primary bowel pathology.
Conclusion
FEB associated with chromosomal abnormality and congenital infection had other ultrasound anomalies. Isolated FEB was associated with a high incidence of placental insufficiency, FGR and poor perinatal outcome, especially in cases with abnormal UAD.
A heterotopic pregnancy is a rare complication of pregnancy in which both extra-uterine (ectopic pregnancy) and intrauterine pregnancy occur simultaneously. The prevalence of heterotopic pregnancy is estimated at 0.6-2.5: 10,000 pregnancy. It is a challenge for obstetrician to manage the tubal pregnancy without interruption of intrauterine pregnancy. Here we describe a case who had left tubal alive ectopic pregnancy & also intrauterine alive pregnancy simultaneously after a natural conception. This patient was managed successfully with laparoscopic left salpingectomy, and intrauterine pregnancy has been continuing. There are some precautions during laparoscopic procedure & post operative period which can help for continuation of intrauterine pregnancy. In our clinical experience, this is an extreme rare disorder and we feel interest to report this case. A heterotopic pregnancy can result from a natural conception; it requires a high index of suspicious for early and timely diagnosis; a timely intervention can result in a successful outcome of the intrauterine fetus.
Cervical pregnancy is a rare variety of Ectopic pregnancy. It is a life threatening form of ectopic pregnancy. The diagnosis of cervical pregnancy can be missed by an unsuspecting mind inspite of the routine use of first trimester Ultrasonography. Careful evaluation is necessary for immediate proper management of such case.DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10474Bang Med J (Khulna) 2011: 44(1&2) 28-30
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