New sonographic feature (C‐sign) to improve the prenatal accuracy of jejunal atresia

Abstract

Objectives: To describe a new sonographic feature of the C-sign for prenatal diagnosis of jejunal atresia and evaluate its role in prenatal jejunal atresia, particularly preceding bowel dilatation and polyhydramnios. Methods: This was a retrospective study from a tertiary maternal hospital. Patients with prenatal sonographic examination and confirmed small bowel atresia postdelivery were included. All sonographic images were reviewed by two senior sonographers. Comparison of sonographic images between prenatal jejunal and ileal atresia using the C-sign resembles the shape of the entire duodenum and other traditional sonographic features. The control group without bowel atresia was assessed for the presence of the C-sign. Results: The C-sign and combined bowel dilatation with polyhydramnios were more frequent in jejunal atresia than ileal atresia, but the C-sign can be used to detect jejunal atresia earlier. The C-sign can be more likely to diagnose jejunal atresia in persisting bowel dilatation and polyhydramnios. The C-sign was not reported in any of the control fetuses. Conclusion:The C-sign is a new sonographic feature that can be used to improve the prenatal accuracy and early detection of jejunal atresia. However, further prospective validation is needed.

Prenatal detection of gastrointestinal bubbles since early pregnancy: Clues to correct diagnosis

“…We have demonstrated that triple bubble and quadribubble, as expected, represent a more distal obstruction. A similar finding was recently reported as the C-sign of jejunal atresia; however, during the third trimester, 18 John et al found in their retrospective series of 58 fetuses with prenatal suspected or postnatal confirmed small bowel atresia that when small bowel atresia was suspected before the third trimester, accuracy was poor. They suggested that an ultrasound after 32 weeks should be performed to confirm the presence of both polyhydramnios and bowel dilatation.…”

Prenatal detection of major congenital malformations in a cohort of 19 367 Danish fetuses with a complete follow‐up six months after birth

“…Our low prenatal DR of malformations in the digestive system is in line with other studies. A common challenge for these malformations is that the prenatal ultrasound signs can be nonspecific and transient 24,25 . Further, these malformations may not be visible at the second‐trimester scan and are reported to appear during the late second and third trimesters 7,21 .…”

“…A common challenge for these malformations is that the prenatal ultrasound signs can be nonspecific and transient. 24,25 Further, these malformations may not be visible at the second-trimester scan and are reported to appear during the late second and third trimesters. 7,21 Overall, there is a low correlation between ultrasound signs and malformations in the digestive system seen after birth.…”