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Echogenic fetal bowel

Case contributed by Alexandra Stanislavsky
Diagnosis certain

Presentation

Fetal assessment at 16 weeks. Mum concerned due to prior child with anomalies, and was due to be traveling around the time of routine 20 week scan.

Patient Data

Age: 35 years
Gender: Female
ultrasound

Selected images demonstrate increased echogenicity of several bowel loops with persists and remains brighter than bone when gain is reduced (last image). The remainder of the study was normal.

Case Discussion

The finding of fetal echogenic bowel has a number of pathologic associations, including aneuploidy, TORCH (particularly CMV) infections, cystic fibrosis, IUGR and FDIU.  It should therefore prompt a recommendation of amniocentesis, referral for genetic counseling (where available), TORCH and CF carrier status screening and close growth monitoring through later pregnancy.

That being said, echogenic bowel is often transient, and in the majority of cases fetuses with isolated echogenic bowel have normal postnatal outcomes.

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