Prenatal ultrasound bowel finding and its impact on perinatal outcome: a referral centre experience.

Objective: To evaluate perinatal outcome in a selected group of fetuses with a prenatal diagnosis of isolated echogenic bowel or bowel dilation or both to improve perinatal management and family counselling. Methods: A retrospective study conducted at the Reference Center for Perinatal Medicine and Surgery from 2011 to 2022. The study population was divided into three groups: hyperechogenicity; dilation; contemporary presence of hyperechogenicity and dilation, without other structural or genetic anomalies. The perinatal outcomes studied were: regression rate of prenatal ultrasound data, gestational age at delivery, birth weight and the need for postnatal surgery. Results: A total of 174 fetuses were included in the study (83 hyperechogenicity, 31 dilations and 60 hyperechogenicity + dilation of the loops).Survival to birth was 100%, with a median gestational age at delivery of 38.5 weeks (range 30.4 – 41.5) and an incidence of delivery <36 weeks of 13.4% and <34 weeks of 2.3%.The median birth weight was at the 33rd percentile and 17.7% of newborns had a weight <3rd percentile. For both outcomes there was no significant difference between the three groups.9.8% of newborns underwent surgery within the first week of life. The surgery rate was significantly higher in the dilation group than in the hyperechogenicity group and in the hyperechogenicity + dilation cases than in the hyperechogenicity alone.Analyzing the group of surgical versus non-surgical newborns, there were no significant differences in terms of birth weight and growth restriction, while a higher rate of birth <36 weeks occurred in the surgical group (p 0.03).The ultrasound regression rate was significant in the hyperechogenicity group (75%, p <0.0001) and in the hyperechogenicity + dilation cases (19.5%, p <0.0043).In the group of surgical newborns, no regression of the ultrasound data was observed compared to the non-surgical ones in which the regression was >50% (p<0.0001). Conclusion: Fetal bowel dilatation and echogenicity are important US findings in prenatal care that warrant careful evaluation and follow-up. Recognizing the clinical significance of these ultrasound markers and offering appropriate counselling and diagnostic tests can help to guide expectant parents and healthcare providers in making decisions regarding the health of the neonate. [ABSTRACT FROM AUTHOR]