ECHOGENIC FETAL BOWEL DURING THE 2ND TRIMESTER - CLINICAL IMPORTANCE

Clinical outcomes of 95 second-trimester fetuses prospectively conside red to have echogenic bowel at ultrasound were compared with a control group of 110 consecutive second-trimester fetuses. Among the 95 fetus es in the study group, 64 (67%) had moderately echogenic (grade 2) or markedly echogenic (grade 3) bowel relative to the liver. Among the 11 0 fetuses in the control group, only two (1.8%) had moderately echogen ic (grade 2) bowel; the rest (98.2%) had isoechoic (grade 0) or mildly echogenic (grade 1) bowel relative to the liver. Adverse outcomes occ urred in 45 of the 95 fetuses (47%) with echogenic bowel compared with eight of the 110 fetuses (7.27%) in the control group (P < .01; relat ive risk, 6.5; 95% confidence interval, 3.2, 13.1). Adverse outcomes i ncluded chromosomal abnormalities, intrauterine growth retardation, fe tal demise, or other fetal anomalies. Within the study group, adverse outcomes occurred in 40 of the 64 fetuses (62%) with grade 2 or 3 bowe l echogenicity, compared with five of the 31 fetuses (16%) with grade 1 echogenicity. Echogenic bowel is associated with an increased risk o f adverse fetal outcome and this risk is confined primarily to grades 2 and 3 echogenicity.