Prenatal ultrasound diagnosis, prognosis and chromosome analysis of fetal bowel dilatation

Abstract

Objective: To investigate the relationship among the prenatal ultrasound, prognosis and chromosome results of fetal bowel dilatation. And in order to further improve the positive rate of prenatal chromosome examination operation, and reduce the risk of missed diagnosis. Methods: Ninety fetuses who were diagnosed as fetal bowel dilatation by prenatal ultrasound from June 2013 to December 2015 in the Second hospital of Jilin University were enrolled. Chromosomes were examined by amniotic cavity puncture or umbilical cord blood puncture. The change of fetus's bowel was monitored periodically by prenatal ultrasound. The normal bowel movement of newborns was a good prognosis. The abdominal X ray or barium contrast radiography was performed in the newborns who did not have normal bowel movement after delivery. Patients underwent surgery or conservative treatment after diagnosis. Fetal karyotype analysis of aborted fetus was carried out by amniotic cavity puncture and umbilical cord blood before induction of labor. Autopsy was performed after induced labor. Patients who were not continued examination in our hospital were followed up by telephone. Results: Among the 90 fetuses, there are 11 cases of duodenum dilatation, 38 cases of jejunum and ileum dilatation, 41 cases of colorectal dilatation. Ten cases of duodenum dilatation were confirmed by autopsy after induced labor, and one case was lost in follow-up. Chromosome examination revealed 3 cases of 21- three body syndrome, 1 case of 18- three body syndrome, 1 case of chromosomal translocation. In 38 cases of jejunum and ileum dilatation, bowel dilatation of 26 cases had decrease or no obvious increase with good prognosis. Six cases of induced labor, 3 cases of receive surgery after birth, 2 cases of postoperative survival, and 3 cases of loss of follow-up. Chromosome examination revealed 1 case of 21- three body syndrome and 1 case of chromosomal translocation. In 41 cases of colorectal dilatation, 29 cases had good prognosis. Five cases were aborted, 1 case of fetal death, 2 cases died within 1 month after birth, 2 cases received surgery after birth and survived after operation, and 2 cases of loss of follow-up. Conclusions: Clinical prognosis and the associated risk of chromosome abnormalities in patients with fetal bowel dilatation are different in terms of its expansion location and extent of the different, which need to a specific analysis of specific situations.