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Rubesova E, Moeremans M. MR Imaging of the Fetal Gastrointestinal Anomalies. Magn Reson Imaging Clin N Am 2024; 32:489-496. [PMID: 38944436 DOI: 10.1016/j.mric.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Fetal MR imaging has been shown to be a useful tool for the diagnosis of fetal gastro-intestinal pathologies. To recognize the various pathologies, it is, however, essential to know the normal MR imaging appearance of the fetal bowel at various gestational ages. By providing additional information to ultrasound in case of a fetal gastrointestinal anomaly, MR imaging helps to improve planning for the delivery, postnatal management, and improves parental counseling.
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Affiliation(s)
- Erika Rubesova
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, 725 Welch Road, Palo Alto, CA 94304, USA.
| | - Marine Moeremans
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, 725 Welch Road, Palo Alto, CA 94304, USA
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Sherer DM, Catala N, Ebner M, Walters E, Kheyman M, Zinn H, Dalloul M. Sonographic findings of transient marked proximal bowel dilatation in a growth-restricted fetus at 35 weeks' gestation. Radiol Case Rep 2024; 19:1753-1757. [PMID: 38384702 PMCID: PMC10877134 DOI: 10.1016/j.radcr.2024.01.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/05/2024] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Etiologies underlying the relatively infrequent third-trimester sonographic depiction of dilated fetal bowel include (functional or mechanical) bowel obstruction, intestinal atresia, volvulus, annular pancreas, intestinal malrotation, intussusception, gastrointestinal duplications, cystic fibrosis-associated meconium ileus, congenital chloride diarrhea, microvillus inclusion disease, intestinal neuronal dysplasia, and meconium plug syndrome. Fetal bowel obstruction may be associated with aneuploidy (mostly Trisomy 21 in association with esophageal or duodenal atresia), and rarely select microduplications or deletions. We present unusual sonographic findings associated with transient marked proximal fetal bowel dilatation in association with concurrent development of oligohydramnios, in a growth-restricted fetus at 35 weeks' gestation. This case supports that upon observation of dilated loops of fetal bowel, while not negating the potential need for delivery secondary to potential bowel compromise, consideration should be given for observation in anticipation of potential spontaneous resolution of this condition, especially among growth-restricted fetuses with decreased amniotic fluid volume in prematurity.
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Affiliation(s)
- David M. Sherer
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, and the Department of Radiology State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Natalia Catala
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, and the Department of Radiology State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Megan Ebner
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, and the Department of Radiology State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Erin Walters
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, and the Department of Radiology State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Mila Kheyman
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, and the Department of Radiology State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Harry Zinn
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, and the Department of Radiology State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Mudar Dalloul
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, and the Department of Radiology State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
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Wolder D, Swat A, Wolak P, Zmelonek-Znamirowska A, Białek K, Rokita W, Kaczmarek P, Świercz G. Enhanced Diagnostic Capabilities: Ultrasound Imaging of Fetal Alimentary Tract Obstruction with Advanced Imaging Technologies. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e943419. [PMID: 38444155 DOI: 10.12659/ajcr.943419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Congenital malformations of the alimentary tract constitute 5% to 6% of newborn anomalies, with congenital intestinal atresia being a common cause of alimentary tract obstruction. This study explores advanced ultrasound diagnostic possibilities, including 2D, HDlive, HDlive inversion, and HDlive silhouette imaging modes, through the analysis of 3 cases involving duodenal and intestinal obstructions. Congenital malformations of the alimentary tract often present challenges in prenatal diagnosis. The most prevalent defect is congenital intestinal atresia leading to alimentary tract obstruction, with an incidence of approximately 6 in 10 000 births. We focused on advanced ultrasound diagnostic techniques and their applications in 3 cases of duodenal and intestinal obstructions. CASE REPORT Three cases were examined using advanced ultrasound imaging modes. The first patient, diagnosed at week 35 of gestation, revealed stomach and duodenal dilatation. The second, identified at week 32, had the characteristic "double bubble" symptom. The third, at week 31, also had double bubble symptom and underwent repeated amnioreduction procedures. HDlive, HDlive inversion, and HDlive silhouette modes provided intricate visualizations of the affected organs. Prenatal diagnosis of alimentary tract obstruction relies on ultrasound examinations, with nearly 50% of cases being diagnosed before birth. CONCLUSIONS Advanced ultrasound imaging modes, particularly HDlive silhouette, play a crucial role in diagnosing fetal alimentary tract obstruction. These modes offer detailed visualizations and dynamic evaluations, providing essential insights for therapeutic decisions. The study emphasizes the importance of sustained fetal surveillance, a multidisciplinary approach, and delivery in a level III referral center to ensure specialized care for optimal outcomes.
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Affiliation(s)
- Daniel Wolder
- Department of Obstetrics and Gynecology, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Adrian Swat
- Department of Obstetrics and Gynecology, Regional Hospital in Kielce, Kielce, Poland
| | - Przemysław Wolak
- Department of Obstetrics and Gynecology, Jan Kochanowski University of Kielce, Kielce, Poland
| | | | - Katarzyna Białek
- Department of Obstetrics and Gynecology, Medical University of Łódź, Łódź, Poland
| | - Wojciech Rokita
- Department of Obstetrics and Gynecology, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Piotr Kaczmarek
- Department of Obstetrics and Gynecology, Medical University of Łódź, Łódź, Poland
| | - Grzegorz Świercz
- Department of Obstetrics and Gynecology, Regional Hospital in Kielce, Kielce, Poland
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