title: Fetal hyperechogenic bowel may indicate congenital cytomegalovirus disease responsive to immunoglobulin therapy.
abstract: OBJECTIVE
  To determine whether fetal hyperechogenic bowel is associated with a poor outcome with or without immunoglobulin therapy.
  
  
  METHODS
  Sixteen pregnant women whose 17 fetuses had hyperechogenic bowel were followed by a protocol of offering additional serologic testing, amniocentesis, hyperimmunoglobulin (HIG), serial ultrasounds, and evaluation of their children.
  
  
  RESULTS
  Of 17 fetuses with hyperechogenic bowel, 13 showed hyperechogenic bowel as a single or first ultrasound sign compared to four who showed it concomitantly or after other ultrasound abnormalities appeared (P = 0.02). Of the 17 fetuses with hyperechogenic bowel, nine were treated with HIG. Eight of the nine were normal at birth and during a follow-up of 3-8 years. One treated fetus is deaf at 4 years of age. A significantly different result (P < 0.0004) occurred among seven untreated fetuses who were each severely affected at 2-7 years of age, and the remaining one died soon after preterm birth. Among seven of nine fetuses (77.8%) of treated mothers the fetal hyperechogenic bowel resolved after HIG administration. There were no significant differences between treated and untreated fetuses for gestational age at maternal infection, gestational age at birth, and birth weight.
  
  
  CONCLUSIONS
  Hyperechogenic bowel may be a marker of congenital cytomegalovirus (CMV) disease, which may be prevented by HIG.
authors.affiliation: Maternal-Infant Department, University and San Salvatore Hospital of L'Aquila, L'Aquila, Italy. nigrogio@libero.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nigro
authors.forename: Stuart P
authors.initials: SP
authors.lastname: Adler
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Gatta
authors.forename: Giulio
authors.initials: G
authors.lastname: Mascaretti
authors.forename: Anastasios
authors.initials: A
authors.lastname: Megaloikonomou
authors.forename: Renato
authors.initials: R
authors.lastname: La Torre
authors.forename: Stefano
authors.initials: S
authors.lastname: Necozione
mesh_terms: D000328:Adult; D003586:Cytomegalovirus Infections / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D058535:Echogenic Bowel / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007116:Immunization, Passive; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy* / Q000821:virology; D011379:Prognosis; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data; D055815:Young Adult