Clinical evaluation of isolated nonvisualized fetal gallbladder.
OBJECTIVE
Isolated nonvisualized fetal gallbladder (INVFGB) is relatively rare. In most cases, the gallbladder will eventually be detected. In some cases however, INVFGB may be associated with serious abnormalities, cystic fibrosis (CF), aneuploidy, and agenesis of the gall bladder. We describe a clinical evaluation of prenatally diagnosed INVFGB.


METHODS
Cases of nonvisualized gallbladder were first evaluated by serial scans. Cases with no additional malformations were designated as INVFGB, and were further evaluated by mutation analysis for CF, and amniocentesis for karyotype and microvillar membrane enzymes (MME).


RESULTS
A total of 22 cases of nonvisualized gallbladder were detected. Of these, 2 had additional malformations, and 3 were excluded because of incomplete evaluation. Of the remaining 17 cases, 3 (17.6%) had adverse outcomes: 1 case of CF, 1 case of 47,XXX, and 1 case of multiple congenital anomalies detected only postnatally. Abnormal levels of MMEs were detected in 3 cases, 1 of which was diagnosed with CF. In 2 cases, the gallbladder was not detected even after birth, but development is normal.


CONCLUSIONS
Evaluation of INVFGB should include genetic counselling, amniocentesis for karyotype and MME analysis, CFTR mutation analysis and repeated ultrasound scans.
Ochshorn
Yifat
Y
Lis Maternity hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Rosner
Guy
G
Barel
Dalit
D
Bronshtein
Moshe
M
Muller
Francoise
F
Yaron
Yuval
Y
D000015:Abnormalities, Multiple; D000328:Adult; D000649:Amniocentesis; D000782:Aneuploidy; D041321:Chromosomes, Human, X; D003550:Cystic Fibrosis / Q000150:complications / Q000000981:diagnostic imaging; D003582:Cytogenetics / Q000379:methods; D005260:Female; D005704:Gallbladder / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D005705:Gallbladder Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D007621:Karyotyping; D008871:Microvilli / Q000201:enzymology; D011247:Pregnancy; D011379:Prognosis; D012729:Sex Chromosome Aberrations; D025064:Sex Chromosome Disorders / Q000150:complications / Q000235:genetics; D050033:Thyroid Dysgenesis / Q000000981:diagnostic imaging / Q000196:embryology; D016216:Ultrasonography, Prenatal