Defining an Evaluation Protocol for the Infant with Fetal Echogenic Bowel

Area of Science:

• Perinatology
• Neonatal Medicine
• Medical Imaging

Background:

• Fetal echogenic bowel (FEB) is a finding on prenatal ultrasound that can be associated with adverse pregnancy outcomes.
• A standardized approach is needed to evaluate infants with FEB to ensure appropriate management and reduce healthcare costs.

Purpose of the Study:

• To develop and evaluate an algorithm for pediatricians managing infants diagnosed with fetal echogenic bowel (FEB).
• To ensure comprehensive evaluation for potential complications while minimizing unnecessary interventions and associated costs.

Main Methods:

• Prospective cohort study of neonates diagnosed with FEB via Level 2 anatomy ultrasound.
• Inclusion of perinatal genetic counseling, third-trimester fetal surveillance (kick counts, growth scans, nonstress tests/BPP), and postnatal evaluations.
• Statistical comparison of findings using chi-square test.

Main Results:

• Of 70 infants diagnosed with FEB, 52 delivered at the study center; 5.8% had intrauterine fetal demise, and 7.6% had unaffected twins.
• Most neonatal outcomes, including NICU admissions, were attributed to prematurity rather than FEB itself.
• The developed algorithm, while not showing significant results in this cohort, is noted for its ease of implementation.

Conclusions:

• The majority of infants diagnosed with FEB exhibit a normal physical examination post-delivery.
• Neonatal complications and NICU admissions in FEB cases are primarily linked to prematurity.
• FEB serves as a soft marker indicating potential fetal abnormalities and risks, necessitating careful evaluation.