PRENATAL ULTRASOUND DIAGNOSIS OF GASTROINTESTINAL MALFORMATIONS

Prenatal ultrasonography is commonly used to detect fetal structural a bnormalities. The aim of this study was to evaluate the reliability of fetal sonography in the detection of congenital gastrointestinal malf ormations (GIM), From a prospective database of all major structural f etal anomalies detected by ultrasound over 3 years in a region with a population of 3.5 million and an annual birth rate of 52,000, 294 repo rts of GIM were identified and reviewed, There were 220 confirmed case s of GIM, of which only 35 (16%) had been correctly identified prenata lly. Of 84 prenatal diagnoses of GIM, only 35 (42%) were confirmed pos tnatally. Prenatal ultrasound was most reliable in the detection of du odenal obstruction (55% confirmed cases identified prenatally) and lea st reliable in malformations of the hindgut, Of 44 cases of nonspecifi c sonographic bowel abnormality leg, echogenic bowel) with adequate fo llow-up, only 12 (27%) had a confirmed GIM after delivery, This study demonstrates that the prenatal ultrasound scan is still unreliable in the detection or exclusion of fetal GIM, and consequently clinicians i nvolved in prenatal sonography or counselling should exercise caution in making such diagnoses. Copyright (C) 1997 by W.B. Saunders Company.