Is fetal hyperechoic bowel on second-trimester sonogram an indication for amniocentesis?

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Obstet Gynecol. 1994 May;83(5 Pt 1):647-51.

Is fetal hyperechoic bowel on second-trimester sonogram an

indication for amniocentesis?
Bromley B1, Doubilet P, Frigoletto FD Jr, Krauss C, Estroff JA, Benacerraf BR.

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Abstract
OBJECTIVE: To determine the clinical significance of hyperechoic bowel seen sonographically in
second-trimester fetuses.
METHODS: Fifty fetuses (0.6%) with echogenic bowel were identified sonographically from a
population of 8680 consecutive second-trimester fetuses over 21 months. The fetal bowel was
considered hyperechoic if its echogenicity was similar to that of surrounding bone. Follow-up was
obtained through medical record review.
RESULTS: Twenty-nine of 50 fetuses (58%) were normal; eight (16%) were aneuploid, including six
Down syndrome, one trisomy 13, and one Turner syndrome. All eight fetuses with aneuploidy had
sonographic anomalies in addition to the echogenic bowel. Eight of 50 fetuses (16%) were growth-
retarded, and five others (10%) had normal karyotypes but are still undelivered. Among the eight
growth-retarded fetuses, there were five intrauterine or neonatal deaths, one elective abortion, and
two survivors. In addition, the six fetuses with Down syndrome and echogenic bowel represented
12.5% of all second-trimester Down syndrome fetuses karyotyped in our laboratory during the study
period. Combining results from the present study (six Down syndrome fetuses) with three studies
from the literature (21 additional Down syndrome fetuses), a total of 27 fetuses with echogenic
bowel and Down syndrome were identified, 11 (40.7%) of whom had no other sonographic findings.
We calculate that if 1,000,000 second-trimester fetuses were scanned, 5105 would have
hyperechoic bowel as the only finding, of whom 71 would have Down syndrome and 5034 would
not. The risk of Down syndrome in fetuses with isolated hyperechoic bowel is, therefore, 71 in 5105

https://www.ncbi.nlm.nih.gov/pubmed/8164918 Page 1 of 2
Is fetal hyperechoic bowel on second-trimester sonogram an indication for amniocentesis? - PubMed - NCBI 3/6/20, 10:56 AM

or 1.4%.
CONCLUSION: The finding of isolated hyperechoic bowel in the second trimester should prompt
genetic counseling and consideration of karyotypic analysis.

PMID: 8164918
[Indexed for MEDLINE]

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