Isolated fetal echogenic bowel in a retrospective cohort: The role of infection screening
Giulia Masini1, Luana Maggio1, Laura Marchi1
1Fetal Medicine Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Objective:
Fetal echogenic bowel (FEB) is an ultrasonographic marker of fetal infection. We aimed to determine the utility of infection screening when FEB is isolated.
Study Design:
Retrospective observational study of isolated FEB cases between 2006-2014. Infection screening included toxoplasmosis, rubella, syphilis, cytomegalovirus (CMV), herpes simplex virus and parvovirus B19. Fetal karyotyping, screening for cystic fibrosis (CF) and follow-up scans were also offered, according to international standards. Incidence of infection and 95% confidence interval (CI) were calculated.
Results:
148 patients with 154 fetuses were included. 4.7% of mothers developed acute infection: four patients developed CMV infection (2.7%, 95% CI 1.1-6.9%), in two fetuses infection was confirmed with amniocentesis and pregnancies were terminated; Parvovirus B19 infection was detected in 2 patients (1.4%, 95% CI 0.4-5.0) and confirmed in one fetus, which developed anemia; there was one toxoplasmosis maternal infection (0.7%, 95% CI 0.1-3.8%) treated with spyramicin, whose fetus was not infected. Percentage of chromosomal/genetic abnormalities was 3.2%, CF 1.3%, intra-amniotic bleeding 1.3%, FGR 34% and other ultrasonographic abnormalities at follow-up scans 18%.
Conclusions:
The association between isolated FEB and fetal infection is uncommon (1.9% in our population). CMV maternal infection screening is supported by our findings, whereas screening for other infections needs to be further investigated.
Insights
Isolated fetal echogenic bowel (FEB) is rarely linked to fetal infection, occurring in only 1.9% of cases. Screening for cytomegalovirus (CMV) infection is recommended, but further research is needed for other infections.
Area of Science:
- Maternal-Fetal Medicine
- Infectious Diseases in Pregnancy
- Prenatal Diagnosis
Background:
- Fetal echogenic bowel (FEB) is an ultrasound finding that can indicate fetal infection.
- The clinical utility of infection screening in cases of isolated FEB requires clarification.
Purpose of the Study:
- To evaluate the effectiveness of infection screening in pregnancies with isolated fetal echogenic bowel.
- To determine the incidence of fetal infections and other abnormalities in isolated FEB cases.
Main Methods:
- Retrospective observational study of 148 patients with isolated FEB (2006-2014).
- Infection screening included toxoplasmosis, rubella, syphilis, cytomegalovirus (CMV), herpes simplex virus, and parvovirus B19.
- Fetal karyotyping, cystic fibrosis screening, and follow-up scans were performed.
Main Results:
- A 1.9% incidence of confirmed fetal infection was observed.
- Cytomegalovirus (CMV) infection occurred in 2.7% of mothers, and Parvovirus B19 in 1.4%.
- Chromosomal/genetic abnormalities (3.2%), cystic fibrosis (1.3%), and fetal growth restriction (34%) were also noted.
Conclusions:
- Isolated FEB has an uncommon association with fetal infection (1.9%).
- Screening for maternal CMV infection is supported by these findings.
- The necessity of screening for other infections in isolated FEB warrants further investigation.
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