Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy.
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
J Clin Ultrasound. 2023 Sep;51(7):1172-1178. doi: 10.1002/jcu.23528. Epub 2023 Aug 8.
Echogenic fetal bowel (EB) is a prenatal ultrasound finding (0.2%-1.4% of all pregnancies) defined as bowel of similar or greater echogenicity than surrounding bone. In fact, the ultrasound assessment is strongly subjective with inter-observer variability. The pathophysiology depends on the underlying condition, apparently related with meconium stasis and hypercellularity. It is often an isolated finding, with possible association with other structural anomalies. About the origin, it was observed in fetuses with cystic fibrosis, congenital infections, thalassemia, intraamniotic bleeding, fetal growth restriction. Fetuses with EB are at increased risk of adverse perinatal outcome, such as intrauterine growth restriction, placental dysfunction and perinatal death, highlighting the need for a thorough antenatal management and post-natal follow-up. It seems to be associated with a plenty of conditions, such as a poor fetal outcome, fetal growth restriction and placental dysfunction. Therefore management requires a multidisciplinary approach with different specialties' involvement and the prognosis is influenced by the underlying pathophysiology. In this complex scenario, the present review aims to define the clinical pathway which should be offered to pregnant women in case of finding of fetal EB ultrasound marker, to rule out any suspected pathological cause.
胎儿肠回声增强（EB）是产前超声的一种发现（占所有妊娠的 0.2%-1.4%），定义为肠回声与周围骨相似或更强。事实上，超声评估具有很强的主观性，观察者间存在差异。其病理生理学取决于潜在的疾病，显然与胎粪淤积和细胞增多有关。它通常是一个孤立的发现，可能与其他结构异常有关。关于其起源，在囊性纤维化、先天性感染、地中海贫血、羊膜内出血、胎儿生长受限的胎儿中均有观察到。肠回声增强的胎儿发生不良围产儿结局的风险增加，如宫内生长受限、胎盘功能障碍和围产儿死亡，这突出了需要进行彻底的产前管理和产后随访。它似乎与许多情况有关，如不良的胎儿结局、胎儿生长受限和胎盘功能障碍。因此，管理需要多学科方法，涉及不同专业，并受潜在病理生理学的影响。在这种复杂的情况下，本综述旨在为发现胎儿 EB 超声标志物的孕妇定义应提供的临床路径，以排除任何可疑的病理性原因。
