Isolated fetal echogenic bowel in a retrospective cohort: The role of infection screening

Masini, Giulia; Maggio, Luana; Marchi, Laura; Cavalli, Iolanda; Ledda, Cristina; Trotta, Michele; Pasquini, Lucia

doi:10.1016/j.ejogrb.2018.10.017

Cited by 13 publications

(21 citation statements)

References 29 publications

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“…One thousand twenty‐eight articles were identified, 49 were assessed with respect to their eligibility for inclusion (Table S1) and 25 studies were included in the systematic review (Table 1, Figures 1). 1,13‐36 These 25 studies included 12 971 fetuses with EB on ultrasound; of those 2832 (21.8%, 95% CI 21.1‐22.6) were isolated, defined as EB with no associated major structural anomalies at the time of diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…Eighteen studies 13,14,16‐22,24,25,28‐30,33‐36 (1530 fetuses) explored the incidence of chromosomal anomalies in fetuses with a prenatal diagnosis of isolated EB. Overall, chromosomal anomalies occurred in 3.3% (95% CI 2.4‐4.2; 50/1530) of the fetuses with isolated EB.…”

Section: Resultsmentioning

confidence: 99%

“…41,42 Congenital infections have also been associated with EB in the published literature. 13,19 Fetuses with congenital infections, especially…”

Section: Implications For Clinical Practicementioning

confidence: 99%

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Outcome of fetal echogenic bowel: A systematic review and meta‐analysis

et al. 2021

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The main aim of this systematic review was to explore the outcome of fetuses with isolated echogenic bowel (EB) on antenatal ultrasound. Inclusion criteria were singleton pregnancies with isolated EB no associated major structural anomalies at the time of diagnosis. The outcomes observed were: chromosomal anomalies, cystic fibrosis (CF), associated structural anomalies detected only at follow-up scans and at birth, regression during pregnancy, congenital infections, intrauterine (IUD), neonatal (NND) and perinatal (PND) death. Twenty-five studies (12 971 fetuses) were included. Chromosomal anomalies occurred in 3.3% of the fetuses, mainly Trisomy 21 and aneuploidies involving the sex chromosomes. Cystic fibrosis occurred in 2.2%. Congenital infections affected 2.2%, mainly congenital Cytomegalovirus (CMV) infection. The majority of fetuses with EB experienced regression or disappearance of the EB at follow-up scans. Associated anomalies were detected at a follow-up scan in 1.8%. Associated anomalies were detected at birth and missed at ultrasound in 2.1% of cases. IUD occurred in 3.2% of cases while the corresponding figures for NND and PND were 0.4% and 3.1%. Fetuses with EB are at increased risk of adverse perinatal outcome, highlighting the need for a thorough antenatal management and postnatal follow-up. Assessment during pregnancy and after birth should be performed in order to look for signs of fetal aneuploidy, congenital infections and associated structural anomalies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Outcome of fetal echogenic bowel: A systematic review and meta‐analysis

et al. 2021

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“…Echogenic bowel is a classical US sign of fetal infection although it may be overestimated . It may be due to direct damage to the fetal intestine or as a result of other potential sequelae of congenital infection, such as ascites, intra‐amniotic bleeding or FGR.…”

Section: Infection In Pregnancymentioning

confidence: 99%

The MRI spectrum of congenital cytomegalovirus infection

et al. 2020

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Human cytomegalovirus (CMV) is an ubiquitous pathogen, with a high worldwide seroprevalence. When acquired in the prenatal period, congenital CMV (cCMV) is a major cause of neurodevelopmental sequelae and hearing loss. cCMV remains an underdiagnosed condition, with no systematic screening implemented in pregnancy or in the postnatal period. Therefore, imaging takes a prominent role in prenatal diagnosis of cCMV. With the prospect of new viable therapies, accurate and timely diagnosis becomes paramount, as well as identification of fetuses at risk for neurodevelopmental sequelae. Fetal magnetic resonance imaging (MRI) provides a complementary method to ultrasound (US) in fetal brain and body imaging. Anterior temporal lobe lesions are the most specific finding, and MRI is superior to US in their detection. Other findings such as ventriculomegaly, cortical malformations and calcifications, as well as hepatosplenomegaly, liver signal changes and abnormal effusions are unspecific. However, when seen in combination these should raise the suspicion of fetal infection, highlighting the need for a full fetal assessment. Still, some fetuses deemed normal on prenatal imaging are symptomatic at birth or develop delayed cCMV-associated symptoms, leaving room for improvement of diagnostic tools. Advanced MR sequences may help in this field and in determining prognosis, but further studies are needed.

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“…Isolated minor ultrasonographic anomalies are evaluated as a variant of normal fetal anatomy in the second trimester fetal ultrasonography (1)(2)(3). Hyperechogenic bowel (HEB) is one of the minor anomalies and was first described by Lince et al (4).…”

Section: Introductionmentioning

confidence: 99%

Perinatal Outcome of Fetal Echogenic Bowel: A Single-Center Retrospective Cohort Study

Şal

Cömert

Ekici

et al. 2020

Gynecol Obstet Reprod Med

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Objective: The aim of this study is to evaluate perinatal outcome of fetal echogenic bowel. Study Design: In this retrospective cohort study, fetuses with echogenic bowel diagnosed and followed in our center between 2013-2017 were included. Fetuses and infants were evaluated in terms of antenatal comorbidities and postnatal persistent diseases. Infants were followed-up to June 2018 from time of diagnosis. Demographic questionnaire and face to face interview were used to obtain data including immune system diseases and respiratory system pathologies in infants. Results: A total of 100 fetuses with echogenic bowel were included in the study. Fetal aneuploidy was detected in 7 (7%) cases. Trisomy 21 was the most common aneuploidy and identified in 4 (4%) cases. Other chromosomal disorders were tetrasomy 12p (1%), 69XXX (1%) and 46 XX, t (2,22) (9q9) (1%). A fetal echogenic bowel was associated with major congenital malformations in 25 (%25) cases. Cardiac abnormality was the most prevalent (%7). First and second trimester vaginal bleeding history was found in 5 pregnant women. In 3 case with isolated echogenic bowel (no congenital malformation and aneuploidy), lactose intolerance, celiac disease, and non-obstructive hydrocephalus were diagnosed in early childhood. Conclusion: Isolated fetal echogenic bowel which can be considered as a soft marker for aneuploidy may be associated with lactose intolerance and celiac disease. Further clinical studies are warranted to evaluate this relationship.

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Isolated fetal echogenic bowel in a retrospective cohort: The role of infection screening

Cited by 13 publications

References 29 publications

Outcome of fetal echogenic bowel: A systematic review and meta‐analysis

Outcome of fetal echogenic bowel: A systematic review and meta‐analysis

The MRI spectrum of congenital cytomegalovirus infection

Perinatal Outcome of Fetal Echogenic Bowel: A Single-Center Retrospective Cohort Study

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