Are fetuses with isolated echogenic bowel at higher risk for an adverse pregnancy outcome? Experiences from a tertiary referral center

Objective: The purpose of this study was to determine the risk of poor perinatal outcome in normal karyotype second-trimester fetuses with the sonographic finding of isolated echogenic bowel.

Method: Medical records, ultrasonographic findings and outcome details were reviewed for 97 cases of isolated fetal echogenic bowel, after excluding cases of aneuploidy and major congenital anomalies, and compared with a cohort of 400 fetuses without pathologic intra-abdominal findings.

Results: The incidence of echogenic bowel during the 14-year study period was 0.8%. Eighty (82.5%) pregnancies resulted in healthy, live-born infants. Congenital infection and cystic fibrosis was reported in 6.2% and 4.4%, respectively. The incidence of intrauterine growth restriction and intrauterine fetal demise was significantly higher in the group of isolated echogenic bowels compared with the control group (9.9% versus 1.3%, p ≤ 0.001; 8.9% versus 0.5% p ≤ 0.001).

Conclusion: Echogenic bowel is a risk factor for an adverse pregnancy outcome, even in normal karyotype fetuses without congenital anomalies. This information should be considered when counseling patients after midtrimester echogenic bowel is diagnosed.