Hyperechogenic fetal bowel: a prospective analysis of sixty consecutive cases

Ghose, Ishika; Mason, Gerald; Martinez, Delia; Harrison, Karen; Evans, Janet; Ferriman, Emma; Stringer, Mark D.

doi:10.1111/j.1471-0528.2000.tb13242.x

Cited by 43 publications

(29 citation statements)

References 11 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings are similar to the results of the current study with respect to the rate of prenatal demise and the high incidence of normal birth in children with HB. Another study by Ghose, et al reported similar results with 82% of the fetuses with isolated HB in their study having normal outcome (7). …”

Section: Discussionsupporting

confidence: 64%

Neonatal outcomes associated with intestinal abnormalities diagnosed by fetal ultrasound

Ruiz¹,

Thatch²,

Fisher³

et al. 2009

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Purpose Intestinal abnormalities are sometimes seen during antenatal testing, however the postnatal importance of these findings has not been well established. We evaluated whether abnormal intestinal appearance on fetal ultrasound (US) was ultimately related to neonatal outcome. Methods Fetal US exams from 2003–2006 were evaluated. Hyperechogenic bowel was defined as having the echogenicity comparable to bone, and dilated bowel was identified based on the sonographer’s assessment. Persistence or resolution of US findings on subsequent US exams and eventual outcomes were assessed. Cases were categorized as hyperechogenic or dilated, and then sub-grouped based on whether or not the US finding resolved. Results Sixty-eight fetuses had either hyperechogenic (n=48) or dilated bowel (n=20) on antenatal US. In 56 cases, complete data were available for analysis. Of 44 liveborn infants, 11 (25.0%) had an abdominal abnormality and 33 (75.0%) were normal at birth. Compared to those with dilated bowel, fetuses with hyperechogenic bowel had a higher rate of prenatal demise (20.8% vs 10%) but a lower rate of abnormality at birth (10.3% vs 53.3%). Hyperechogenic bowel resolved on subsequent US more frequently than dilated bowel (65.5% vs 20.0%). In both groups, all fetuses with sonographic resolution were normal at birth. Three of 9 fetuses (33.3%) that had persistently hyperechogenic bowel were born with an abnormality and all were found to have meconium peritonitis or meconium ileus. In the 12 cases where dilated bowel did not resolve, 8 (66.7%) were eventually born with an abnormality, most commonly intestinal atresia. Conclusions Hyperechogenic and dilated bowel are associated with a significant rate of fetal demise. Hyperechogenicity is more common than dilation and is more likely to be transient. Dilated bowel is more often associated with neonatal abnormality than hyperechogenic bowel. Persistence of fetal ultrasound findings predicts a higher likelihood of abnormality in the neonate.

show abstract

Section: Discussionsupporting

confidence: 64%

Neonatal outcomes associated with intestinal abnormalities diagnosed by fetal ultrasound

Ruiz¹,

Thatch²,

Fisher³

et al. 2009

Journal of Pediatric Surgery

View full text Add to dashboard Cite

show abstract

“…CF has been reported in 2.5-9.9% of cases of hyperchogenic bowel (Corteville et al 1996;Ghose et al 2000;Muller et al 1998Muller et al , 2002Scotet et al 2002;Slotnick and Abuhamad 1996). In a large series of 641 pregnancies reported by Muller et al, CF accounted for 3.1% of fetal bowel anomalies and 20/21 cases with two CFTR mutations had ''severe'' genotypes associated with classical CF (Muller et al 2002).…”

Section: Introductionmentioning

confidence: 93%

Comprehensive description of CFTR genotypes and ultrasound patterns in 694 cases of fetal bowel anomalies: a revised strategy

et al. 2010

View full text Add to dashboard Cite

Fetal bowel anomalies may reveal cystic fibrosis (CF) and the search for CF transmembrane conductance regulator (CFTR) gene mutations is part of the diagnostic investigations in such pregnancies, according to European recommendations. We report on our 18-year experience to document comprehensive CFTR genotypes and correlations with ultrasound patterns in a series of 694 cases of fetal bowel anomalies. CFTR gene analysis was performed in a multistep process, including search for frequent mutations in the parents and subsequent in-depth search for rare mutations, depending on the context. Ultrasound patterns were correlated with the genotypes. Cases were distinguished according to whether they had been referred directly to our laboratory or after an initial testing in another laboratory. A total of 30 CF fetuses and 8 cases compatible with CFTR-related disorders were identified. CFTR rearrangements were found in 5/30 CF fetuses. 21.2% of fetuses carrying a frequent mutation had a second rare mutation, indicative of CF. The frequency of CF among fetuses with no frequent mutation was 0.43%. Correlation with ultrasound patterns revealed a significant frequency of multiple bowel anomalies in CF fetuses. The results emphasize the need to search for rearrangements in the diagnosis strategy of fetal bowel anomalies. The diagnostic value of ultrasound patterns combining hyperechogenic bowel, loop dilatation and/or non-visualized gallbladder reveals a need to revise current strategies and to offer extensive CFTR gene testing when the triad is diagnosed, even when no frequent mutation is found in the first-step analysis.

show abstract

“…(2–7) Previous reports have also suggested an increased incidence of intrauterine growth restriction (IUGR) and intrauterine fetal demise (IUFD) in fetuses with echogenic bowel, with reported incidences ranging from 14.0–23.3% for IUGR and from 3.8–8.0% for IUFD. (7–11) Fetal redistribution of blood flow to vital organs with resultant bowel hypoperfusion and ischemia is the proposed explanation for the hyperechoic appearance of the fetal bowel in these situations. (8,10,12)…”

Section: Introductionmentioning

confidence: 99%

Echogenic Bowel on Second-Trimester Ultrasonography

Goetzinger

Cahill

Macones

et al. 2011

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Objective-To estimate if echogenic bowel diagnosed on second-trimester ultrasound has an independent risk association with intrauterine growth restriction (IUGR) and intrauterine fetal demise.Methods-This is a retrospective cohort study of all patients with singleton gestations who presented to our institution for second-trimester ultrasound between 1990 and 2008. Study groups were defined by the presence or absence of echogenic bowel. Primary outcomes were IUGR, defined as birth weight less than the 10 th percentile, and intrauterine fetal demise at 20 weeks or more of gestation. Univariable and multivariable logistic regression analyses were used to estimate the risk of intrauterine fetal demise and IUGR in fetuses with echogenic bowel. Analyses were repeated after excluding cases of aneuploidy, cytomegalovirus (CMV) infection, other major congenital anomalies, and abnormal second-trimester serum screening results.Results-Of 64,048 patients, the incidence of echogenic bowel was 0.4%. Of these, echogenic bowel was an isolated finding in 188 (72.3%) cases. There were 579 (0.9%) cases of intrauterine fetal demise and 8,173 (12.8%) cases of IUGR in the entire cohort. After excluding cases of aneuploidy and CMV infection, the incidence of IUFD was 7.3% in the echogenic bowel group compared to 0.9% in the non-echogenic bowel group, translating to an absolute risk increase (ARI) of 6.4%. The incidence of IUGR in the echogenic bowel group was 19.5% compared to 12.9% in the non-echogenic bowel group (ARI=6.6%). After controlling for potential confounders, echogenic bowel was signficantly associated with both IUFD (aOR 9.6, 95% CI 5.8-15.9) and IUGR (aOR 2.1, 95% CI 1.5-2.9) This risk association remained significant even when evaluating echogenic bowel as an isolated sonographic finding. Conclusion-The presence of echogenic bowel on ultrasound is independently associated with an increased risk for both IUGR and IUFD. Serial growth assessment and antenatal testing may be warranted in these patients.

show abstract

Hyperechogenic fetal bowel: a prospective analysis of sixty consecutive cases

Cited by 43 publications

References 11 publications

Neonatal outcomes associated with intestinal abnormalities diagnosed by fetal ultrasound

Neonatal outcomes associated with intestinal abnormalities diagnosed by fetal ultrasound

Comprehensive description of CFTR genotypes and ultrasound patterns in 694 cases of fetal bowel anomalies: a revised strategy

Echogenic Bowel on Second-Trimester Ultrasonography

Contact Info

Product

Resources

About