Hyperechoic fetal bowel: The perinatal consequences

Bahado‐Singh, Ray O.; Morotti, Raffaella; Copel, I. A.; Mahoney, Maurice J.

doi:10.1002/pd.1970141014

Cited by 49 publications

(23 citation statements)

References 16 publications

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“…Sepulveda et al [17] did not find an association between FEB and an increased incidence of CF mutations in 45 pregnancies at low risk for this disease. In contrast, in a review of 357 published cases, Bahdo-Singh et al [5] found CF mutations in 25.6% of cases with FEB. In a recent article, Slotnick and Abuhamad [7] stated that they offer their patients genetic couseling, parental CF-carrier testing, and amniocentesis for fetal karyotype only when the echogenicity of the fetal bowel is equal to or greater than that of the iliac crest.…”

Section: Discussionmentioning

confidence: 93%

Evaluation of Fetal Echogenic Bowel in the Second Trimester

Yaron

Hassan²,

Geva

et al. 1999

Fetal Diagn Ther

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Previous studies cite different possible etiologies for fetal echogenic bowel (FEB). The purpose of this study was to evaluate the possible etiologies for second-trimester FEB, and to provide clinical guidelines for evaluation of this finding. The study included 79 patients diagnosed with FEB in the second trimester. Fifteen cases (19%) were associated with maternal vaginal bleeding. Of these, 12 patients underwent amniocentesis, 9 of which had visible blood products in the amniotic fluid. Seven cases (8.9%) had associated severe malformation. Seven other cases (8.9%) were noted in multifetal pregnancies. Five fetuses (6.3%) had evidence of bowel obstruction or perforation not associated with cystic fibrosis (CF). Chromosomal aberrations were found in 5 fetuses (6.3%). Intrauterine infection with cytomegalovirus, herpes simplex virus, varicella-zoster virus, or parvovirus B-19 was documented in 5 patients (6.3%). Three cases (3.8%) were associated with subsequent unexplained stillbirth. Two fetuses (2.5%) were found to be affected by CF. Finally, in 30 cases (38%), no obvious reason for FEB was found. We conclude that the evaluation of second-trimester FEB should include targeted ultrasound for associated malformations, infectious studies, DNA analysis for CF mutations, amniocentesis for chromosomal analysis and evaluation of the amniotic fluid for degraded blood products, and an autopsy in cases of stillbirth. Even when no apparent reason is found, pregnancies should be considered at high risk for poor outcome.

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Section: Discussionmentioning

confidence: 93%

Evaluation of Fetal Echogenic Bowel in the Second Trimester

Yaron

Hassan²,

Geva

et al. 1999

Fetal Diagn Ther

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“…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.…”

Section: Hyperechoic Bowelmentioning

confidence: 99%

Sonographic markers of fetal trisomies: second trimester.

Nyberg

Souter

2001

J of Ultrasound Medicine

112

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Objective. Second-trimester sonographic findings of fetal trisomy may include structural abnormalities or sonographic markers of fetal aneuploidy. Unlike structural anomalies, sonographic markers of fetal aneuploidy are insignificant by themselves with regard to outcome, are nonspecific-most frequently seen in normal fetuses, and are often transient. Our objective was to review the secondtrimester sonographic findings of the major trisomic conditions, trisomies 13, 18, and 21. Methods. We reviewed a number of the most commonly accepted markers, including nuchal thickening, hyperechoic bowel, echogenic intracardiac focus, renal pyelectasis, shortened extremities, mild cerebral ventricular dilatation, and choroid plexus cysts. Markers associated with trisomy 21 were emphasized. Results. The sensitivity of sonography for detection of fetal trisomic conditions varies with the type of chromosome abnormality, gestational age at the time of sonography, reasons for referral, criteria for positive sonographic findings, and the quality of the sonography. As an estimate, 1 or more sonographic findings can be identified in approximately 90% of fetuses with trisomy 13, 80% of fetuses with trisomy 18, and 50% to 70% of fetuses with trisomy 21 (Down syndrome). Conclusions. The presence or absence of sonographic markers can substantially modify the risk of fetal Down syndrome and is the basis of the so-called genetic sonogram. Because maternal biochemical and sonographic markers are largely independent, combined risk estimates will result in even higher detection rates than either alone.

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“…2,5,7,8 Muller and coworkers, however, described a prospective study of 87 patients with hyperechoic bowel in a low-risk population and found a 4% risk of chromosomal anomalies and 5% risk of cystic fibrosis. 15 Similarly, Vintzileos and Egan 13 reported a poor sensitivity of 7%.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional ultrasonographic technology to assess and compare echodensity of fetal bowel, bone, and liver in the second trimester of pregnancy.

Khandelwal¹,

Silva²,

Chan³

et al. 1999

Journal of Ultrasound in Medicine

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Increased fetal bowel echogenicity in the second trimester is used as a marker for prenatal diagnosis of Down syndrome. The diagnosis of hyperechogenicity is subjective. We sought to quantify and correlate fetal bowel echogenicity with liver and bone in 47 normal fetuses, using three‐dimensional ultrasonographic technique and objective measurement of gray scale distribution. No significant change was found in the organs' echogenicity between 15 and 24 weeks of gestation, the optimal time for detection of fetal chromosomal anomalies. A wide variability in bowel density was noted within the normal group, which could explain its poor sensitivity for the detection of Down syndrome. Bowel echodensity correlates better with liver density than with bone density. Thus, comparison of bowel to liver echogenicity, even with two‐dimensional sonography, may prove to be a more effective clinical tool in the evaluation of fetal intra‐abdominal echodensities.

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Hyperechoic fetal bowel: The perinatal consequences

Cited by 49 publications

References 16 publications

Evaluation of Fetal Echogenic Bowel in the Second Trimester

Evaluation of Fetal Echogenic Bowel in the Second Trimester

Sonographic markers of fetal trisomies: second trimester.

Three-dimensional ultrasonographic technology to assess and compare echodensity of fetal bowel, bone, and liver in the second trimester of pregnancy.

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