Hyperechoic intestine in the fetus has been given reasons for whom. Hyperechoic intestine in the fetus: what is this pathology associated with, its diagnosis and treatment. Is it possible to cure hyperechoic bowel?

The term “hyperechoic intestine” refers to an overly bright image of the fetal intestine on the monitor of an ultrasound machine. At the same time, you need to know that the echogenicity of the intestine is greater than the echogenicity of other internal organs located next to it. If the brightness of the intestines approaches the brightness of the bone image, they speak of hyperechogenicity.

Hyperechoic intestine in the fetus is detected in 0.5% of cases in the 2nd trimester of pregnancy. This kind of intestine may be a variant of the norm, or it may be observed if the fetus swallows blood that is not digested and remains in the intestinal lumen. In later pregnancy, hyperechoic bowel indicates the development of meconium peritonitis or meconium ileus, or is a symptom of chickenpox infection.

Causes of hyperechoic intestine in the fetus

If, during an ultrasound examination, a hyperechoic intestine is detected in the fetus, then the expectant mother should not panic, because it is likely that this condition of the fetus may change after some time. But we should not forget that hyperechogenicity may indicate:

hereditary chromosomal diseases (for example, Down syndrome);
intrauterine growth retardation;
intrauterine infection of the fetus.

It must be remembered that the establishment of hyperechogenicity does not directly indicate the presence of Down syndrome, but is evidence of an increased risk of developing this syndrome. In this case, it is worth contacting a geneticist to double-check the results of the biochemical test. It is also necessary to be examined for the presence of antibodies to cytomegalovirus, herpes simplex virus, toxoplasmosis, parovirus, and rubella.

To exclude, you need to additionally check:

whether there is a lag in the size of the head and body of the fetus from the gestational age;
is there any lack of water;
Is the blood flow in the vessels of the uterus and fetus, and the placenta reduced?

If none of the symptoms are confirmed, then the diagnosis is excluded, and another cause of hyperechogenicity must be established.

Consequences of hyperechoic intestine in the fetus

Data obtained by various researchers suggest that the presence of hyperechoic intestine is the basis for classifying a pregnant woman as a risk group, since she may give birth to a child with. Despite the fact that hyperechoic intestine can indicate various pathologies of the fetus, Most of the cases of detected hyperechogenicity resulted in the birth of children without anomalies.

Treatment of hyperechoic intestine in the fetus

In cases where intestinal hyperechogenicity is established, the woman should undergo a comprehensive prenatal examination, which will include studying the karyotype, assessing the ultrasound anatomy of the child, monitoring his condition, and performing tests for intrauterine infection. Only after this can the doctor give the woman the necessary recommendations for treatment and further management of pregnancy.

What is hyperechoic bowel?

Hyperechoic bowel is a term that refers to increased echogenicity (brightness) of the bowel on ultrasound images. Detection of hyperechoic intestine is NOT a V malformation of the intestine, but simply reflects the nature of its ultrasound image. It must be remembered that the echogenicity of the normal intestine is higher than the echogenicity of its neighboring organs (liver, kidneys, lungs), but such intestine is not considered hyperechoic. Only intestines whose echogenicity is comparable to the echogenicity of fetal bones are called hyperechoic.

Why is the fetal intestine hyperechoic?

Sometimes hyperechoic intestine is detected in completely normal fetuses, and this sign may disappear with dynamic ultrasound.
Increased echogenicity of the intestine may be a manifestation of chromosomal diseases of the fetus, in particular Down syndrome. Therefore, when hyperechoic bowel is detected, a careful assessment of fetal anatomy is performed. However, when identifying hyperechoic
intestines, we can only talk about an increased risk of Down syndrome, since such changes can also occur in completely healthy fetuses.
Sometimes hyperechoic bowel may be a sign of intrauterine fetal infection.
Hyperechoic bowel is often found in fetuses with intrauterine growth restriction. However, this will necessarily reveal a lag in the size of the fetus from the gestational age, oligohydramnios, and impaired blood flow in the vessels of the fetus and uterus. If none of the above is detected, then the diagnosis of fetal growth restriction is excluded.

What to do if hyperechoic intestine is detected in the fetus?

You should contact a geneticist who will once again evaluate the results of the double and (or) triple biochemical test. The geneticist will give the necessary recommendations for further management of pregnancy.
It is recommended to undergo testing to determine antibodies to rubella, cytomegalovirus, herpes simplex virus, parvovirus B19, and toxoplasmosis.
control ultrasound after 4 weeks to assess the rate of fetal growth and its functional state.

Today, a detailed examination of all organs and systems of the child was carried out using ultrasound. There were no other signs of Down syndrome.

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The Leningrad Regional Clinical Hospital has introduced screening for pregnant women without an appointment. The cost of the study is 3100 rubles.

Pregnancy is an important stage in the life of every woman. That is why you need to take a special responsibility in following all the recommendations prescribed by the doctor, and most importantly, do not neglect various studies. The main procedure that the expectant mother should undergo regularly is ultrasound. It helps to monitor how the fetus develops and to promptly identify unexpected deviations in its formation. One of them is hyperechoic intestine in the fetus.

What does hyperechoic bowel mean?

To understand what this phrase means, you need to refer to ultrasound terminology. Echogenicity is a concept denoting the level of density of tissue examined by an ultrasound device. On the ultrasound screen this is manifested in the brightness of the display of certain organs.

Normally, the intestines of the unborn child should be higher in echogenicity than the liver, kidneys or lungs, but lower than the bones. If the brightness of the intestine is equal to the brightness of the fetal bone tissue, it is said to be hyperechogenic.

Examinations to identify such pathology are carried out only in the second trimester. Until the sixteenth week, any data will be inaccurate and uninformative. Although already at this time the doctor should pay attention to the level of echogenicity of the organs so as not to miss the problem in the future. The longer the pregnancy at which hyperechogenicity was detected, the more likely the presence of abnormalities in fetal development.

Symptoms of pathology

In addition to ultrasound readings, a number of accompanying signs may indicate anomalies of intestinal development in the fetus:

Disturbances in the formation of other fetal organs, as well as delay in general development;
Discrepancy between the size of the unborn baby and the parameters considered normal;
Reduced amount of amniotic fluid;
Tachycardia in the embryo, characterized by increased heart rate (about two hundred beats per minute);
The presence of a severe fetal defect - omphalocele - in which the abdominal organs turn outward through a pathologically dilated umbilical cord;
Anomaly in the development of the child’s brain: partial or complete absence of its division into hemispheres;
Violation of uteroplacental blood flow.

At the first suspicion of hyperechoic intestine in the fetus, as well as in the event of any of these signs, the doctor must send the pregnant woman for additional examinations, including genetic ones.

Reasons for the development of intestinal hyperechogenicity in the fetus

There are several explanations for the anomaly in question. One of the common ones is a diagnostic error. That is why experts advise undergoing an ultrasound in several more clinics if increased echogenicity was detected in the first one.

Often repeated diagnostics by another specialist using different equipment shows the opposite result.

In addition, hyperechoic fetal intestine can be caused by the following reasons:

If after the next ultrasound it was concluded that the fetus has a hyperechoic intestine, there is no need to despair and panic. It is important to remember that excessive suspiciousness of the mother harms the baby. All you need to do is follow your doctor’s recommendations for special tests. Often, increased echogenicity on ultrasound is observed in absolutely healthy children, so no preliminary conclusions can be made without examinations.

What to do if hyperechoic intestine is detected

It is impossible to talk about any treatment, be it medicinal or surgical, until an accurate diagnosis has been determined.

An intestine with increased echogenicity is not a disease, but only a sign that may indicate the presence of one. Many women, having learned about this problem and read horror stories on forums, rush to extremes, look for ways to be cured, and even resort to traditional medicine. All this is dictated by groundless panic and can cause enormous harm to the health of the mother and unborn child.

What to do if an ultrasound showed hyperechoic fetal intestine? Usually the doctor recommends undergoing a series of tests that will help understand the reasons that caused the phenomenon:

Your doctor may recommend all types of tests or just some of them. Sometimes you have to wait quite a long time for results – up to three weeks. After receiving them, a decision is made on further actions: treatment, if possible, or termination of the pregnancy (for example, if the diagnosis of Down syndrome is confirmed). The latter is carried out only with the consent of the mother.

This sign may indicate the presence of chromosomal or congenital abnormalities in the child. But the pathology of the embryo is not confirmed in all cases. Therefore, increased echogenicity on ultrasound is not a death sentence.

The phenomenon requires a thorough examination of the amniotic fluid, mother’s blood and consultation with a geneticist. Treatment includes surgery or monitoring the newborn. In the case of chromosomal abnormalities, the issue is resolved individually.

Causes

What are the causes of hyperechoic intestine in the fetus? Etiological factors may be:

Down syndrome. In this case, in addition to hyperechogenicity, the fetus will show other signs of the pathological process (heart defects, ventricular septal defects).
Intrauterine infection. Infectious agents that can cause such manifestations include cytomegalovirus, parvovirus, toxoplasma, herpes virus, rubella, and chickenpox.
Congenital anomalies of the gastrointestinal tract (Hirschsprung's disease, duodenal atresia).
Developmental delay (body parts are smaller than they should be at a given stage of pregnancy). In this case, symptoms such as oligohydramnios, reduced uterine or placental blood flow, fetal tachycardia, umbilical cord hernia, and undivided cerebral hemispheres will also be observed.
Meconium ileus.
Meconium peritonitis.
Fetoplacental insufficiency.

Which doctor treats hyperechoic intestine in a fetus?

Hyperechogenicity of the fetal intestine is a reason to visit a geneticist. He will conduct the necessary examinations and determine the presence or absence of chromosomal pathologies. In the absence of genetic disorders, the woman is observed and treated by a gynecologist. After the baby is born, you may need the help of a pediatric surgeon.

Diagnostics

The diagnosis of “hyperechoic intestine” can be made after the following studies:

Blood test for the presence of antibodies to herpes viruses, rubella, chickenpox, paramyxovirus. The presence of immunoglobulins M in the blood to one of the listed pathogens indicates an acute infection. If class G antibodies are detected, this indicates a long-term illness.
Mniocentesis is the collection of amniotic fluid under ultrasound control. Amniotic fluid is examined for chromosomal abnormalities and intrauterine infection of the embryo. The conclusion will be ready in 21 days.
Cordocentesis - blood is taken from the fetus through the umbilical cord, which is examined in the same way as amniotic fluid.
Repeated ultrasound examination after 1 month. In most cases, hyperechoic bowel is not re-identified.
Consultation with a geneticist.
CTG (if necessary) - prescribed by the obstetrician-gynecologist leading the pregnancy.

Treatment

How to treat intestinal hyperechogenicity in the fetus? Treatment of this pathology depends on the etiological factor that led to its occurrence. Intrauterine infection will require treatment for a bacterial or viral infection. Intestinal obstruction, meconium ileus, meconium peritonitis, or duodenal atresia will require surgical treatment.

In the absence of symptoms of an acute abdomen, such children are monitored dynamically and surgery is not performed.

If meconium peritonitis develops, bleeding may occur. It leads to the formation of a short intestine.

Consequences

What are the consequences of hyperechoic intestine in the fetus? In 8% of cases, the embryo dies in utero. In less than 1% of cases, death occurs after the birth of a child during the first month of life. Overall, adverse effects were observed in 49%.

Hyperechoic intestine can lead to the development of a pathology such as cystic fibrosis in a newborn. However, in most cases, children who had this ultrasound sign in utero do not experience any diseases.

Hyperechoic intestine in the fetus is an ultrasound sign indicating the likely presence of anomalies. Intrauterine infections, genetic defects, in particular Down syndrome, intestinal obstruction or peritonitis, developmental delay or fetoplacental insufficiency can lead to increased echogenicity of the intestine. To make an accurate diagnosis, additional examinations are necessary.

Useful video about fetal ultrasound

One of the unpleasant and dangerous diagnoses that can be made even at the stage of intrauterine development is hyperechoic intestine in the fetus. This is a disease that can be detected before the baby is born. As a rule, it is determined in the 2nd or 3rd trimester of pregnancy.

Diagnostic measures

This problem will be determined during an ultrasound examination. Doctors prescribe similar procedures in the first (12 weeks), second (20 weeks) and third trimester (32 weeks). During this procedure, you can see many different pathologies and evaluate the overall development of the baby. An ultrasound shows the condition of internal organs, including the intestines.

If there are problems with it, certain measures must be taken. Knowing about the presence of pathology, its further development in some cases can be prevented.

The baby's intestines can be seen already at 6-7 weeks of pregnancy. During this period, it is located outside the abdominal cavity. At this stage, it develops poorly, since most of its growth begins at the beginning of the second trimester.

However, already at the first scheduled ultrasound examination, the expectant mother has the opportunity to check whether there are any problems with this organ. If the doctor suspects that the baby may have hyperechoic intestines, the woman will be sent for additional tests. As a rule, to confirm the diagnosis, a three-fold biochemical blood test, repeated ultrasound, and examination of the material for antibodies of a certain type are performed.

Experts note that in our time, hyperechoic intestine in the fetus is not a rare pathology. This disease can be congenital or hereditary. It is worth noting that such pathology can be completely different in severity. Sometimes hyperechogenicity of the intestine can become an indication for termination of pregnancy.

But in order to fully confirm the presence of a problem, it is necessary to conduct a lot of tests. Only after receiving all the data can we talk about the degree of risk and threat to the life of the unborn baby.

Causes of hyperechoic bowel

Basically, such a pathology develops against the background of a genetic disorder. This suggests that the baby has serious underdevelopment of internal organs and the body as a whole. For example, hyperechoic bowel may hint at Down syndrome.

It is simply impossible to determine exactly what exactly is the cause of the development of such a pathology. However, doctors still identified a certain risk group. First of all, it includes women who suffered a serious infectious disease during the first trimester of pregnancy.

But significant developmental delays are not always accompanied by intestinal hyperechogenicity. In some cases, a similar symptom manifests itself as a minor deviation. If you eliminate the factors that slow down this process, you can solve this problem without risking the development of the fetus. In such a situation, there can be no talk of terminating the pregnancy.

That is why it is very important to timely and correctly determine the degree of risk. Of course, to determine the hyperechoic intestine will require a lot of tests, but this will provide an opportunity to obtain clear information about the degree of risk. If the problem has not gone too far and the deviations in development are insignificant, the methods of modern medicine will be quite sufficient to correct the error and prevent its occurrence in the future.

Symptoms of hyperechoic bowel

Problems with this organ in an unborn baby can be identified already during the first trimester of pregnancy. As a rule, fetal development disorders are accompanied by additional symptoms. If they are present, the doctor should immediately suspect that the unborn baby is developing intestinal hyperechogenicity.

To begin with, it is worth noting that this pathology is characterized by symptoms such as underdevelopment of organs and disruption of the general development of the fetus. As a result, there is always a discrepancy in the size of the child when compared with normal biometric parameters. In addition, the fetus may experience tachycardia, holoprosencephaly, and omphalocele. During pregnancy, oligohydramnios and disruption of uterine and placental blood flow will occur.

If the doctor suspects that the embryo is not developing correctly, the expectant mother should be under close supervision of specialists. Often, in addition to the gynecologist, a geneticist also deals with this problem. In order to make an accurate diagnosis, the doctor must conduct all the necessary tests and take into account the presence of all important symptoms. It is advisable to conduct several examinations at once. It is better if different equipment is involved. For example, it would not hurt for an expectant mother to undergo an ultrasound scan in several clinics at once.

Hyperechogenicity of the intestine sometimes indicates not a genetic developmental abnormality, but premature aging of the placenta. In addition, this may indicate that the mother and unborn child are infected with chickenpox. But this mostly happens in the third trimester of pregnancy.

Association between intestinal hyperechogenicity and Down syndrome

One pathology does not at all indicate the obligatory development of the second. However, the connection between them is often traced. A chromosomal abnormality can be determined after certain diagnostic procedures. Moreover, if there is a suspicion of hyperechoic intestine in the fetus, tests to determine Down's disease are required.

There is no clear connection between hyperechogenicity and the presence of an extra chromosome. But a certain percentage of children who have been diagnosed with a similar pathology are still born with Down syndrome. But they do not always have poor physical health. Most often their problems are related to the heart.

It is very important to promptly determine the presence of pathology and the degree of its complexity. The thing is that at some stages you can minimize the manifestations of the disease, but you need to act quickly. This becomes possible only if the expectant mother does not ignore the doctor’s recommendations and attends all diagnostic procedures, no matter how many they were prescribed. If the problem is identified early, treatment can begin quickly. It is not always possible to completely solve the problem, but in most cases modern medicine can still help.

Is it possible to cure hyperechoic bowel?

Unfortunately, such a pathology cannot always be cured. Most often, it is possible to completely correct the situation if the hyperechoic fetal intestine is due to a disease. Modern medicine cannot cope with chromosomal abnormalities.

If it is revealed that hyperechogenicity and delayed fetal development are caused by a disease, the woman is prescribed special treatment. If the problem was identified at an early stage, then many troubles can be avoided, since the baby will still have a lot of time to grow to normal and be born healthy. Most often, pregnant women are tested for ureaplasmosis, mycoplasmosis or streptococcal bacteria.

Once the underlying cause of fetal growth retardation has been eliminated, intestinal hyperechogenicity and all other associated symptoms should disappear. However, complications may remain after them. For example, such an anomaly can lead to meconium peritonitis. This problem can only be treated surgically. If left untreated, it can lead to bleeding and the development of short bowel syndrome. This is very dangerous and can lead to fetal death. A similar development of the situation is observed in 8% of cases.