OC27.06: Non‐visualisation of the fetal gallbladder (NVFGB) at prenatal ultrasound: cohort study and systematic review of the literature on postnatal outcome

Abstract

i) to investigate the ultrasound characteristics and outcome in fetuses with NVFGB followed in our tertiary university hospital, ii) to provide a comprehensive review of literature on NVFGB. NVFGB was defined as non-visualisation of the gallbladder at two targeted US examination within a 1-week period. Cases of NVFGB managed in our centre were revised and a systematic review of literature was performed. The incidence of chromosomal anomalies, later visualisation of gallbladder, gallbladder agenesis, cystic fibrosis (CF) and Biliary Atresia (BA) in fetuses were assessed isolated and non-isolated NVFGB. 16 cases of NVFGB were followed in our centre, 10 being isolated (62.5%). There was an incidence of 12.5% of BA and 12.5% of gallbladder agenesis while no case of CF was reported. Gallbladder was visualised later in pregnancy or postnatally in 43.8% and 31.3% of cases, respectively. A total of 5 additional studies for a total of 227 cases met inclusion criteria for the systematic review. Overall, 22.0% of fetuses had associated US anomalies, the incidence of chromosomal anomalies in this group was 18.0%, while that of severe conditions (CF or BA) was 39.0% in cases with normal karyotype. Table 1 summarised the results of our review. In case of persistent NVFGB the risk of a severe postnatal condition should be considered. This study provides important information for prenatal counselling. N of studies (n) Fetuses (n/N) I2 (%) Raw % (95% CI) Pooled % (95% CI) 1.3 (0.2-4.7) 1.9 (0.2-5.2) 69.4 (61.9-76.2) 70.4 (61.0-79.0) 24.7 (18.4-31.7) 25.2 (19.0-32.0) 2.4 (0.6-5.9) 3.1 (1.0-6.2) 3.5 (1.3-7.5) 4.8 (2.1-8.4)