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Echogenic fetal bowel during the second trimester: clinical importance
D A Nyberg1, T Dubinsky, R G Resta
1Center for Perinatal Studies, Swedish Hospital Medical Center, Seattle, Wash.
Radiology
|August 1, 1993
Summary
Second-trimester fetuses with echogenic bowel, particularly grades 2 and 3, face a significantly higher risk of adverse outcomes. This includes chromosomal abnormalities, growth restriction, and fetal demise, underscoring the importance of this ultrasound finding.
Area of Science:
- Perinatal Medicine
- Fetal Imaging
- Obstetrics
Background:
- Echogenic bowel on second-trimester ultrasound is an ambiguous finding.
- Its association with adverse fetal outcomes requires further clarification.
Purpose of the Study:
- To compare clinical outcomes of fetuses with echogenic bowel to a control group.
- To assess the risk of adverse outcomes based on the severity of echogenic bowel.
Main Methods:
- Prospective study comparing 95 fetuses with echogenic bowel to 110 controls.
- Ultrasound grading of bowel echogenicity (grades 0-3) relative to fetal liver.
- Follow-up for adverse outcomes including chromosomal abnormalities, growth retardation, fetal demise, and other anomalies.
Main Results:
- 47% of fetuses with echogenic bowel had adverse outcomes versus 7.27% in controls (RR 6.5).
- Grades 2 and 3 echogenic bowel were associated with 62% adverse outcomes.
- Grade 1 echogenicity showed a lower rate of adverse outcomes (16%).
Conclusions:
- Echogenic bowel in the second trimester is linked to increased adverse fetal outcomes.
- The risk is significantly elevated for moderate (grade 2) and marked (grade 3) echogenic bowel.
- This finding necessitates careful evaluation and counseling for expectant parents.