EP26.05: Prenatal and neonatal outcomes of hyperechogenic fetal bowel: report on 184 prenatal cases

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Fate of patients with prenatally diagnosed hyperechogenic bowel (HB) is poorly explored. Aim of present study was to investigate prenatal and perinatal outcomes of fetuses diagnosed with HB. This is a prospective study of all fetal HB cases evaluated in a tertiary referral centre between 2013 and 2020. Fetal and neonatal demise, intrauterine growth retardation (IUGR), associated anomalies, genetic disorders (including cystic fibrosis) and congenital infection were evaluated. Chi-squared test were used as appropriate, p < 0.05 was consider significant. There were 184 pregnancies identified prenatally with HB. Spontaneous resolution of HB was observed in 119 cases. Overall, we observed 5 (3%) cystic fibrosis, 10 (5%) other genetic disorders, 13 (7%) congenital infections, 5 (3%) neonatal deaths, 12 (7%) intestinal anomalies, 24 (13%) other malformations, and 19 (10%) experienced IUGR. IUGR was more common when HB was discovered during 3rd trimester (2nd trimester 7/122 versus 3rd trimester 12/62; p = 0,008). Bowel dilatation was more commonly detected throughout 3rd trimester (2nd trimester 29/122 versus 3rd trimester 35/62; p = 0,0001). When persistent HB were present, an increase rate of congenital infection and bowel dilatation were observed (14% versus 4%; p = 0,03 and 52% versus 23%; p = 0,0007, respectively). We found a significant differences in term on intrauterine growth retardation p = 0,04 also between isolated HB group 3 (4%) and associated anomalies HB group 16 (14%) A significant prevalence of intrauterine growth retardation p = 0,04 (14% versus 4%), congenital anomalies p = 0,0001 (21% versus 1%) and gastrointestinal malformation p = 0,003 (11% versus 0%) was noticed in not isolated HB group. Although spontaneous resolution of HB was commonly observed, a significant proportion of patients challenged serious problems. HB detection is associated with an increased risk of IUGR, bowel dilatation, genetic and malformative disorders, and risk of neonatal death. Active prenatal HB search is warranted to better inform parents, reducing late morbidity and mortality.

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