Analysis of etiological factors and pregnancy outcome in cases of fetal hyperechogenic bowel

Abstract

Objective. The prevalence of fetal hyperechogenic bowel is 0.2% to 1.8%. The aim of this study was to examine etiological factors responsible for pathogenesis of fetal hyperechogenic bowel, to investigate their prognostic importance for the progression and outcome of pregnancy and to assess optimal diagnostic strategy of this condition. Methods. The information on etiological factors and pregnancy outcome were collected through telephone interviews with 40 pregnant women with fetal hyperechogenic bowel found on routine ultrasound examination. The total of 12 (30%) women agreed to provide the required information. Their answers were based on medical documentation, provided during their respective pregnancies. Data were analyzed using descriptive statistics. Results. The most common etiological factor in cases of fetal hyperechogenic bowel is infection with cytomegalovirus during the first two trimesters of the pregnancy, while the presence of the chromosome anomalies and cystic fibrosis are responsible for the occurrence of this clinical entity only in a minority of cases. In one of the analyzed cases (8.3%) Down's syndrome was confirmed in fetus, in four cases (33.3%) cytomegalovirus infection was found, while mutations in the CFTR gene were not found in fetus' parents in any of analyzed cases. Outcome of pregnancy in all cases in which the ultrasound examination showed only the presence of fetal hyperechogenic bowel was live newborn, while in cases with other ultrasound findings the contribution of live newborn was 55 percent. Conclusion. Ultrasound of fetal echogenic bowel during pregnancy is a serious clinical condition that justifies the use of invasive diagnostic procedures and aggressive differential diagnostic search.