Study on the correlation between fetal bowel dilatation and pregnancy outcomes / 中华医学超声杂志（电子版）

ABSTRACT

Objective To explore the ultrasonographic features of fetal gastrointestinal tract dilatation and associated abnormalities. Methods From July 2009 to June 2013, 118 cases of fetal bowel dilatation of detected by prenatal ultrasound in our hospital were followed up for their ultrasonographic changes and pregnancy outcomes. The features of fetal bowel dilatation with associated abnormalities and their impact on pregnancy outcomes were summarized. Results Among the 118 cases of fetuses, 101 cases had small bowel dilatation, including 4 cases with adverse pregnancy outcomes. One case had cleft lip and palate and was aborted during 25th week of pregnancy. The other 3 cases had continuous excess of amniotic lfuid and progressive widening of bowel, the average inner diameter of which was above 30.0 mm. In the 3 cases, 2 cases ended with intrauterine death during 34th week of pregnancy and 1 case ended with death at one week after birth. Among the 97 cases of pregnant women with good pregnancy outcomes, 66 cases (66/97) were solitary bowel dilatation, while the remaining 31 cases (31/97) were associated with abnormal soft markers, e.g., excess or decrease of amniotic lfuid, fetal echogenic bowel, fetal uronephrosis, short femur, single umbilical artery, fetal widened lateral ventricles and placenta overripe, etc. Among the 17 cases of colonic dilatation, 1 case had exessive amniotic lfuid and“double-leaf sign”clumps in abdomen during the second trimester and was proved to be anal atresia post partum, while the remaining 16 cases had the colonic dilatation which were found after 34th week of pregnancy and the widest inner diameter of colon was less than 30.0 mm associated with abnormal soft markers like excess or decrease of amniotic lfuid and fetal echogenic bowel, etc., and associated with good pregnancy outcomes. Conclusions Most fetuses with mild to moderate bowel dilatation had favorable outcomes. During ultrasonic examination, the degree and dynamic change of bowel dilatation shall be observed. If bowel dilatation or increment of amniotic fluid continues or worsens, greater risk of poor prognosis is indicated. The larger inner diameter of the small bowel, the greater risk of poor prognosis. If the fetus with bowel dilatation had echogenic bowel before, the risk of intestinal obstruction is comparatively lower. For the fetus suspected for colonic obstruction and anal atresia, it is more meaningful to observe the intestinal morphology and its changes.