Choi Soo Ran, Won Hye-Sung, Chung Jin Hoon, Lee Mi-Young, Koh Jihye, Lee Yoo Jin
Department of Obstetrics and Gynecology, Inha University College of Medicine, Inha University Hospital, Incheon, Korea.
Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2025 Sep;68(5):382-389. doi: 10.5468/ogs.25114. Epub 2025 Aug 19.
To evaluate the postnatal outcomes of referred cases with abnormal findings in the fetal gallbladder (GB) or cysts in the fetal liver.
This retrospective study included pregnant women referred to a tertiary referral unit, the fetal therapy center at Ulsan Asan Medical Center in Korea, between June 2005 and October 2022. Persistent non-visualization of the fetal gallbladder (NVFGB) was defined as non-visualization at least twice using an ultrasound scan. Antenatal ultrasound findings were obtained from the medical records, and the clinical, radiological, and surgical findings of the babies were reviewed.
A total of 113 referred patients were evaluated. Most enlarged and small GBs were identified as normal or GB stones, sludge, septate GB, or choledochal cysts (CDC). NVFGB was identified postnatally in 77.5% of cases. Persistent NVFGB was identified postnatally as biliary atresia (3/14; 21.4%), hepatic parenchymal disease with cholestasis (2/14; 14.2%), or isolated GB agenesis (6/14; 42.8%). The majority of cysts in the fetal liver cases with visualization of the fetal GB were identified as CDC. Half of the patients (2/4) with CDC who underwent NVFGB were confirmed to have biliary atresia.
Except for persistent NVFGB, most abnormal ultrasound findings in fetal GB were associated with good postnatal outcomes. Cysts in the fetal liver with visualization of the fetal GB did not result in serious adverse outcomes. NVFGB, especially persistent NVFGB with or without cysts in the fetal liver, should be followed up closely prenatally and postnatally.
评估胎儿胆囊（GB）检查结果异常或胎儿肝脏囊肿转诊病例的产后结局。
这项回顾性研究纳入了2005年6月至2022年10月期间转诊至韩国蔚山峨山医学中心胎儿治疗中心（一家三级转诊单位）的孕妇。胎儿胆囊持续不显像（NVFGB）定义为超声扫描至少两次未显示胆囊。从病历中获取产前超声检查结果，并回顾婴儿的临床、放射学和手术检查结果。
共评估了113例转诊患者。大多数增大或缩小的胆囊被确定为正常、胆囊结石、胆汁淤积、分隔胆囊或胆总管囊肿（CDC）。77.5%的病例在出生后被诊断为NVFGB。出生后持续性NVFGB被诊断为胆道闭锁（3/14；21.4%）、伴有胆汁淤积的肝实质疾病（2/14；14.2%）或孤立性胆囊缺如（6/14；42.8%）。在胎儿胆囊显像的胎儿肝脏囊肿病例中，大多数被确定为CDC。接受NVFGB检查的CDC患者中有一半（2/4）被确诊为胆道闭锁。
除持续性NVFGB外，胎儿胆囊大多数异常超声检查结果与良好的产后结局相关。胎儿胆囊显像的胎儿肝脏囊肿未导致严重不良后果。NVFGB，尤其是伴有或不伴有胎儿肝脏囊肿的持续性NVFGB，应在产前和产后密切随访。
