Echogenic material in the fetal gallbladder and fetal disease

The presence of echogenic material within the gallbladder is probably a rare finding in the fetus, and the list of predisposing factors known for postnatal life seems not to be applicable to prenatal diagnosis. In the present study 1656 obstetric scans were performed on referrals to the Unit of Fetal Medicine. No echogenic gallbladder contents were found before 28 weeks. In the subgroup of 523 fetuses who were examined during gestational weeks 28-42, six fetuses were found to have echogenic material in the gallbladder. The echogenicities were found in patients who had the following: extra-amniotic hematoma with intrauterine growth retardation and oligohydramnios, tetralogy of Fallot, trisomy 21 with atrioventricular septal defect and transient ascites, early abnormally distended fetal gallbladder, chromosomal aberration (translocation 10; 11) with bilateral clubfoot, and gastroschisis. Echogenic densities had disappeared at ultrasound scans performed during early postnatal life in four cases, were absent at five weeks in one case, and still present as calculi 8 months after birth in one case. Although no causative conclusions can be drawn from the report, these conditions are suggested as possible predisposing factors for the presence of echogenic material in the fetal gallbladder.