Nonobstructive Diffuse Dilated Bowel Loops: Prenatal Diagnosis, Fetal Characteristics and Neonatal Outcomes

Abstract

Nonobstructive diffuse dilated bowel loops diagnosed in the second half of pregnancy are associated with premature rupture of membranes and premature labor. As neonatal gastrointestinal complications may be anticipated, prenatal parental counseling with a neonatologist and pediatric gastroenterologist should be conducted.

Fetal intestinal loop dilatation: Follow‐up and outcome of a series of 133 consecutive cases (the DILDIG study)

“…Congenital diarrhea was observed at birth in four of the five cases, for which appropriate postnatal care is necessary 28,29 . However, as previously observed by Katz et al 9 . and Amino et al., 30 this typical prenatal appearance was observed in one of our cases in which the infant presented no anomaly at birth.…”

“…Congenital diarrhea was observed at birth in four of the five cases, for which appropriate postnatal care is necessary. 28,29 However, as previously observed by Katz et al 9 and Amino et al, 30 this typical prenatal appearance was observed in one of our cases in which the infant presented no anomaly at birth. Because drainage of amniotic fluid is needed in most cases, this can be the opportunity to perform a biochemical analysis of digestive enzymes and electrolytes in the amniotic fluid and a genetic analysis to confirm the diagnosis.…”

“…Fetal bowel dilatation accounts for 2% of anomalies observed at routine prenatal ultrasound (US) examination and is defined by fluid‐filled intestinal loops at least 15 mm in length and/or 7 mm in diameter 1,2 . Various pathologies are considered, roughly classified as an obstructive process (as digestive tract atresia or stenosis, anorectal malformation) or functional disease (as congenital diarrhea, cystic fibrosis, infectious diseases, and aneuploidies) 3–10 . Dilated bowel loops are generally easy to observe at US examination, but the criteria for optimizing diagnosis, prognosis, and management are not so clear.…”

“…1,2 Various pathologies are considered, roughly classified as an obstructive process (as digestive tract atresia or stenosis, anorectal malformation) or functional disease (as congenital diarrhea, cystic fibrosis, infectious diseases, and aneuploidies). [3][4][5][6][7][8][9][10] Dilated bowel loops are generally easy to observe at US examination, but the criteria for optimizing diagnosis, prognosis, and management are not so clear. The aim of this study was to analyze a series of observations to determine the best prognostic markers in the case of prenatal dilated bowel loops and to clarify the guidelines for prenatal multidisciplinary centers.…”

Sonographic findings of transient marked proximal bowel dilatation in a growth-restricted fetus at 35 weeks’ gestation

“…The differential diagnosis of etiologies underlying the relatively infrequent third-trimester sonographic depiction of dilated fetal bowel includes (functional or mechanical) bowel obstruction, intestinal atresia, volvulus, annular pancreas, intestinal malrotation, intussusception, gastrointestinal duplications, cystic fibrosis-associated meconium ileus, congenital chloride diarrhea, microvillus inclusion disease, intestinal neuronal dysplasia, and meconium plug syndrome [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] . Fetal bowel obstruction may be associated with aneuploidy (mostly Trisomy 21 in association with esophageal or duodenal atresia), and rarely select microduplications or deletions, with a detection rate in cases of low risk of aneuploidy of 3.85% by copy number variation sequencing (CNV-seq) in contrast to 7.69% by whole exome sequencing (WES) [12] , [13] , [14] , [15] .…”