Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy.
Division of Maternal and Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy.
Prenat Diagn. 2021 Mar;41(4):391-399. doi: 10.1002/pd.5638. Epub 2021 Feb 21.
The main aim of this systematic review was to explore the outcome of fetuses with isolated echogenic bowel (EB) on antenatal ultrasound. Inclusion criteria were singleton pregnancies with isolated EB no associated major structural anomalies at the time of diagnosis. The outcomes observed were: chromosomal anomalies, cystic fibrosis (CF), associated structural anomalies detected only at follow-up scans and at birth, regression during pregnancy, congenital infections, intra-uterine (IUD), neonatal (NND) and perinatal (PND) death. Twenty-five studies (12 971 fetuses) were included. Chromosomal anomalies occurred in 3.3% of the fetuses, mainly Trisomy 21 and aneuploidies involving the sex chromosomes. Cystic fibrosis occurred in 2.2%. Congenital infections affected 2.2%, mainly congenital Cytomegalovirus (CMV) infection. The majority of fetuses with EB experienced regression or disappearance of the EB at follow-up scans. Associated anomalies were detected at a follow-up scan in 1.8%. Associated anomalies were detected at birth and missed at ultrasound in 2.1% of cases. IUD occurred in 3.2% of cases while the corresponding figures for NND and PND were 0.4% and 3.1%. Fetuses with EB are at increased risk of adverse perinatal outcome, highlighting the need for a thorough antenatal management and postnatal follow-up. Assessment during pregnancy and after birth should be performed in order to look for signs of fetal aneuploidy, congenital infections and associated structural anomalies.
本系统评价的主要目的是探讨孤立性胎儿肠回声增强（EB）的产前超声结果。纳入标准为：单胎妊娠，诊断时无其他主要结构异常。观察的结果为：染色体异常、囊性纤维化（CF）、仅在后续扫描和出生时发现的相关结构异常、妊娠期间的消退、先天性感染、宫内（IUD）、新生儿（NND）和围产期（PND）死亡。共纳入 25 项研究（12971 例胎儿）。染色体异常发生率为 3.3%，主要为 21 三体和涉及性染色体的非整倍体。囊性纤维化发生率为 2.2%。先天性感染发生率为 2.2%，主要为先天性巨细胞病毒（CMV）感染。大多数 EB 胎儿在后续扫描中经历了 EB 的消退或消失。1.8%的胎儿在后续扫描中发现了相关异常。2.1%的病例在出生时发现了相关异常，但在超声检查中漏诊。IUD 的发生率为 3.2%，NND 和 PND 的相应发生率分别为 0.4%和 3.1%。EB 胎儿围产期不良结局的风险增加，突出了需要进行彻底的产前管理和产后随访。应在妊娠期间和出生后进行评估，以寻找胎儿非整倍体、先天性感染和相关结构异常的迹象。
