Fetüste Sol Subdiyafragmatik Ekojen Odak ve Prognoza Etkisi

Year 2023, Volume: 76 Issue: 1, 45 - 49, 25.05.2023

Gökçe Annaç

https://doi.org/10.4274/atfm.galenos.2023.05924

Abstract

Objectives: The aim of this study was to determine the effect of fetal left subdiaphragmatic echogenic foci (LSEF) on prognosis and to research its clinical significance.

Materials and Methods: In this retrospective study, obstetric ultrasound was performed for 20142 pregnant women, at 16-40 gestational weeks. The fetuses who were diagnosed with LSEF incidentally were included in the study. The number and size of echogenic foci, associated anomalies and serological test results were recorded. The fetuses with LSEF were followed by ultrasound every 4 weeks until delivery, and postnatal ultrasound on the second month of life was performed for the cases who didn’t exhibite resolution.

Results: During the study period, 285 fetuses were found to have 315 LSEFs with a prevalence of 1.4%. Twelve (4.2%) of the fetuses had minor anomalies (7 intracardiac echogenic foci, 4 minimal pyelectasis, 1 hyperechogenic bowel) and one of them (0.3%) had aneuploidy+major anomaly (1 atrioventricular septal defect+Trisomy 21). Intrauterine 274 fetuses (n=286 LSEF) were able to be followed, 242 LSEF (84.6%) disappeared antenatally, 18 LSEF (6.2%) showed regression. In the second month of neonatal period, 6 LSEF (2%) persisted including the case with aneuploidy.

Conclusion: LCEF had no clinically significant effect on the prognosis of the cases without aneuploidy, and postnatal follow up was not recommended for these cases.

Keywords

Echogenicity , Fetus , Isolated , Calcification , Subdiaphragmatic

Ethical Statement

Ethics Committee Approval: The study was approved by the local research ethics committee of İstinye University Clinical Research Ethics Committee (3/2022.F-52). Informed Consent: Informed consent was obtained from all pregnant women to participate in the study. Peer-reviewed: Externally peer-reviewed. Financial Disclosure: The author declared that they did not receive any financial support during the research and authoring of this article.

Supporting Institution

-

Project Number

-

References

• 1. Ji EK, Lee EK, Kwon TH. Isolated echogenic foci in the left upper quadrant of the fetal abdomen: are they significant? J Ultrasound Med. 2004;23:483- 488.
• 2. Hill LM. Ultrasound of fetal gastrointestinal tract. In: Callen PW, editor. Ultrasonography in Obstetrics and Gynecology. 6th ed. Philadelphia, PA: WB Saunders Co; 2000. p. 471.
• 3. Nguyen DL, Leonard JC. Ischemic hepatic necrosis: a cause of fetal liver calcification. AJR Am J Roentgenol. 1986;147:596-597.
• 4. Slotnick RN, Abuhamad AZ. Prognostic Implications of Fetal Echogenic Bowel. Lancet. 1996;347:85-87.
• 5. Pata O, Gunduz NM, Unlu C. Isolated Fetal Liver Calcifications. J Turk Ger Gynecol Assoc. 2012;13:67-69.
• 6. Koopman E, Wladimiroff JW. Fetal intrahepatic hyperechogenic foci: prenatal ultrasound diagnosis and outcome. Prenat Diagn. 1998;18:339- 342.
• 7. Simchen MJ, Toi A, Bona M, et al. Fetal Hepatic Calcifications: Prenatal Diagnosis and Outcome. Am J Obstet Gynecol. 2002;187:1617-1622.
• 8. Kidron D, Sharony R. Fetal liver calcifications: an autopsy study. Virchows Arch. 2012;460:399-406.
• 9. Yamashita Y, Iwanaga R, Goto A, et al. Congenital Cytomegalovirus Infection Associated with Fetal Ascites and Intrahepatic Calcifications. Acta Paediatr Scand. 1989;78:965-967.
• 10. Kogutt MS. Hepatic Calcifications Presumably Due to Congenital Syphilis. AJR Am J Roentgenol. 1991;156:634-635.
• 11. Sahlin E, Sirotkina M, Marnerides A, et al. Fetal calcifications are associated with chromosomal abnormalities. PLoS One. 2015;1-10.
• 12. Tennstedt C, Chaoui R, Vogel M, et al. Pathologic Correlation of Sonographic Echogenic Foci in the Fetal Heart. Prenat Diagn. 2000;20:287-292.
• 13. Achiron R, Seidman S, Afek A, et al. Prenatal ultrasonographic diagnosis of fetal hepatic hyperechogenicities: clinical significance and implications for management. Ultrasound Obstet Gynecol. 1996;7:251-255.
• 14. Friedman AP, Haller JO, Boyer B, et al. Calcified portal vein thromboemboli in infants: radiography and ultrasonography. Radiology. 1981;140:381-382.
• 15. Bronshtein M, Blazer S. Prenatal diagnosis of liver calcifications. Obstet Gynecol. 1995;86:739-743.
• 16. Drose JA, Dennis MA, Thickman D. Infection in utero: US findings in 19 cases. Radiology 1991;178:369-374.
• 17. Shinar S, Agrawal S, Ryu M, et al. Fetal Meconium Peritonitis - Prenatal Findings and Postnatal Outcome: A Case Series, Systematic Review, and Meta-Analysis. Ultraschall Med. 2022;43:194-203.