My baby has a bright bowel on ultrasound scan (Echogenic Bowel)

Introduction

This leaflet is aimed at pregnant women who have been found to have a suspected finding of echogenic bowel on antenatal ultrasound examination.

What is echogenic bowel?

Echogenic bowel is a term used to describe how your baby’s bowel (gut) appears on the ultrasound scan. It means that the bowel appears brighter than expected on the ultrasound scan images.

How common is it?

Echogenic bowel is quite common, and is seen in about 1% (1 in 100) of babies at the routine anomaly scan.

What causes it?

In most cases, no underlying cause is found. In these cases the appearance of the bowel often returns to normal and the baby will be healthy.

Sometimes it may occur due to bleeding within the womb earlier in the pregnancy (which can occur without you noticing). The result of the baby swallowing some of this blood can lead to the bright appearance of the bowel on scan. Swallowing blood is not harmful for your baby.

Unfortunately echogenic bowel can sometimes be related to more serious conditions. A small number of babies with echogenic bowel (2-3%) will have an underlying chromosome problem such as Down’s Syndrome. The possibility of a chromosomal problem may be more likely if your baby is also found to have additional problems on the ultrasound scan as well as echogenic bowel.

You will have already been offered a screening test for Down’s Syndrome, Edward’s Syndrome and Patau’s Syndrome earlier in your pregnancy. If the presence of echogenic bowel is confirmed during your fetal medicine appointment, you will be offered a diagnostic test called an amniocentesis to assess your baby’s chromosomes in more detail. It is entirely up to you if you would like to consider proceeding with this test. (See separate information leaflet.)

Approximately 3% (3 in 100) of babies with echogenic bowel will be found to have cystic fibrosis. Cystic fibrosis is a life-long condition that primarily affects the lungs and also the digestive tract. It is a genetic condition, in which a baby can only be affected if both parents are carriers of a faulty gene. We can perform a blood test to confirm if you and your partner have a faulty gene, in which case your baby is at risk of having cystic fibrosis. If your baby is found to be at risk then we can offer you an amniocentesis to clarify if your baby is affected. All babies born in the UK are also screened for cystic fibrosis on the Newborn Bloodspot Screening which is done five days after birth.

Occasionally echogenic bowel can be due to an infection in the mum that has crossed the placenta to the baby. The most likely infection to cause this is a virus called cytomegalovirus (CMV), which is found to be the cause in approximately 2% (2 in 100) of babies with echogenic bowel. CMV is a common virus that you may have had early in pregnancy without realising, as it often causes no symptoms. Toxoplasmosis is another infection that is less commonly found to cause echogenic bowel. A blood test can be performed to check for both of these.

Some babies with echogenic bowel will be found to have a structural problem with the bowel such as a narrowing or obstruction. This may not be evident until later in the pregnancy or occasionally until after your baby’s birth.

What happens next?

You will have a detailed scan performed in the Fetal Medicine Unit to confirm the echogenic bowel and also to check your baby carefully for any other abnormalities. Not all problems can be detected on ultrasound, but if anything else is found in addition to the echogenic bowel then this will be discussed with you. We will also discuss the additional tests available with you in detail. If any of the tests identifies a problem then we will discuss the implications of this with you.

If no cause is found for the echogenic bowel then you will be offered further scans later in the pregnancy to check your baby’s growth. This is mostly because babies that have echogenic bowel are more likely to have growth problems due to the placenta not functioning to its full potential. The general appearance of the bowel can also be assessed at these appointments.

For further information

For further information please contact:

Fetal Medicine Department,
Royal Victoria Infirmary
(0191) 2825837
Monday –Friday 9-5pm

Be sure to ask questions to the doctor supplying you with this leaflet and make a note of any questions you would like to ask at your next Fetal Medicine Unit appointment.

Antenatal Results and Choices
0845 077 2290 or 0207 713 7486 via mobile

North of Tyne Patient Advice and Liaison Service (PALS)
0800 0320202
Monday to Friday 9.00-4.30pm (answer phone out of hours)
Email: [email protected]