Clinical significance of the prenatal double bubble sign - single institution experience

The objective of this study is to determine the risk of aneuploidy, associated structural anomalies, and pregnancy outcome in the presence of prenatal double bubble sign detection.

We have performed a retrospective study on ultrasound reports and pregnancy outcomes in 42 fetuses with double bubble sign examined in our ultrasound department between 1998 and 2013.

Additional major defects or aneuploidy markers were present in 24 fetuses. Chromosomal abnormalities occurred in 21 cases. There were 35 live births; two pregnancies ended in intrauterine fetal demise; five patients opted for termination of pregnancy because of additional anomalies or abnormal karyotype. Postnatal or postmortem verification revealed duodenal obstruction secondary to intrinsic or extrinsic cause in 40 cases; in one case, proximal jejunal atresia was diagnosed, and one neonate had normal bowel.

Sonographic double bubble sign is associated with a significant rate of major anatomic defects, abnormal karyotype, and unfavorable pregnancy outcome. It is strongly indicative of duodenal obstruction.