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Outcome of infants presenting with echogenic bowel in the second trimester of pregnancy
  1. Hannah D Buiter1,
  2. Marloes A G Holswilder-Olde Scholtenhuis2,
  3. Katelijne Bouman3,
  4. Robertine van Baren4,
  5. Caterina M Bilardo2,
  6. Arend F Bos1
  1. 1Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  2. 2Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  3. 3Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  4. 4Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Hannah Buiter, Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, Groningen 9700 RB, The Netherlands; h.d.buiter{at}umcg.nl

Abstract

Objective Fetal echogenic bowel (FEB) is a soft marker found on second trimester sonography. Our main aim was to determine the outcome of infants who presented with FEB and secondarily to identify additional sonographic findings that might have clinical relevance for the prognosis.

Design We reviewed all pregnancies in which the diagnosis FEB was made in our Fetal Medicine Unit during 2009–2010 (N=121). We divided all cases into five groups according to additional sonographic findings. Group 1 consisted of cases of isolated FEB, group 2 of FEB associated with dilated bowels, group 3 of FEB with one or two other soft markers, group 4 of FEB with major congenital anomalies or three or more other soft markers, and group 5 consisted of FEB with isolated intrauterine growth restriction (IUGR).

Results Of 121 cases, five were lost to follow-up. Of the remaining 116 cases, 48 (41.4%) were assigned to group 1, 15 (12.9%) to group 2, 15 (12.9%) to group 3, 27 (23.2%) to group 4, and 11 (9.5%) to group 5. The outcome for group 1 was uneventful. In group 2 and 3, two anomalies, anorectal malformation and cystic fibrosis, were detected postnatally (6.7%). In group 4, mortality and morbidity were high (78% resp. 22%). Group 5 also had high mortality (82%) and major morbidity (18%).

Conclusions If FEB occurs in isolation, it is a benign condition carrying a favourable prognosis. If multiple additional anomalies or early IUGR are observed, the prognosis tends to be less favourable to extremely poor.

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