Second-trimester echogenic small bowel: an increased risk for adverse perinatal outcome.
2267 singleton fetuses who had one ultrasound examination between 15 and 21 weeks' gestation were prospectively evaluated for echogenic small bowel. Thirty-two cases of echogenic small bowel were detected--a prevalence of 1.4 per cent. Echogenic fetal small bowel was divided into two grades: grade 1, where the small bowel was more echogenic than the liver; and grade 2, where the small bowel had the echogenicity of bone. In contrast to 19/23 fetuses with grade 1 small bowel echogenicity, only 2/9 fetuses with grade 2 echogenic bowel had a normal pregnancy outcome (Fisher's exact test; P < or = 0.01). Complications associated with second-trimester echogenic small bowel included in utero cytomegalovirus infection, second-trimester growth restriction, intrauterine fetal demise, and chromosomal abnormalities. Second-trimester fetal echogenic small bowel is associated with an increased risk of an adverse outcome. The prevalence of perinatal and neonatal complications is significantly greater when small bowel echogenicity approaches that of bone.
Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh, School of Medicine, PA.
L M
LM
Hill
J
J
Fries
J
J
Hecker
P
P
Grzybek
D000328:Adult; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000453:epidemiology; D004314:Down Syndrome / Q000000981:diagnostic imaging / Q000196:embryology; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007421:Intestine, Small / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D007621:Karyotyping; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D015995:Prevalence; D012307:Risk Factors; D016216:Ultrasonography, Prenatal