Isolated fetal echogenic bowel ‘may be benign’

By Nikki Withers, medwireNews Reporter

Results of a Dutch study show that the majority of fetuses with fetal echogenic bowel (FEB) carry a good prognosis.

However, if multiple additional anomalies or early intrauterine growth restriction (IUGR) are observed the prognosis tends to be less favorable, write Hannah Buiter (University of Groningen) and co-authors.

FEB is a soft tissue marker found on second trimester sonography. There are limited data available on the outcome of pregnancies complicated by FEB in the second trimester of pregnancy. To investigate further, Buiter and team reviewed all pregnancies in which the diagnosis of FEB was made in their fetal medicine unit during 2009 to 2010.

In total, 116 cases were included in their analysis. Of these, 48 (41.4%) were diagnosed with isolated FEB (group 1), 15 (12.9%) with FEB with dilated bowel (group 2), and 15 (12.9%) with FEB with one or two other soft markers (group 3).

Twenty-seven (23.2%) of the cases were assigned to group 4 (FEB associated with other major anomalies or three or more additional soft markers) and 11 (9.5%) to group 5 (FEB with isolated IUGR).

The researchers found that the outcome for group 1 was "uneventful." In group 2 and 3, two anomalies - anorectal malformation and cystic fibrosis - were detected postnatally, accounting for 6.7% of these cases. No deaths occurred in any of these groups.

In group 4, mortality and morbidity were high, at 78% and 22%, respectively. Mortality and morbidity were also high in group 5, at a respective 82% and 18%.

Writing in the Archives of Disease in Childhood. Fetal and Neonatal Edition, the researchers say that their study may have immediate implications for fetal healthcare.

"In all groups with FEB, sonographic follow-up and postpartum physical examination by the pediatrician is necessary," they say. "Additional sonographic findings may help to determine prognosis."

They conclude: "These findings may help to stimulate the correct use of diagnostic tools and appropriate counseling of parents during pregnancy."

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