Case Series and Literature Review: Fetal Bowel Dilatation and Its Clinical Significant

Abstract

Ultrasound has limited accuracy for bowel evaluation even in a normal adult. Therefore, during prenatal diagnosis, accidental finding of fetal bowel dilatation is very challenging for obstetrician in identifying and explaining the exact lesions and its clinical significant correlations. Fetal bowel dilatation is an indirect sonographic sign or possible the only sign in predicting probable mechanical or functional bowel obstruction. We reviewed cases of fetus with dilated bowels noted during prenatal care in the past three years, from January 2015 until March 2017 in National Cheng Kung University Hospital (NCKUH) and College of Medicine, Tainan, Taiwan. A total number of 11010 cases visited NCKUH for prenatal ultrasound screening from January 2015 until March 2017. We identified a total number of 629(5.7%) cases with congenital fetal anomalies and 19(0.17%) cases with fetal bowel dilatation. Fetal with gastroschisis and omphalocele were not including in this study. Out of the 19 cases with fetal bowel dilatation, 6(31.6%) fetuses showed poor outcome after delivery. Despite lower rate of sensibility and specificity, ultrasound plays an important role in the management and diagnosis of fetal bowel dilatation. It offers an opportunity for parental counseling and for choosing patients who need transfer to a specialized center which is of upmost importance as it allows prompt treatment and reduces the risk of complications.