Undetectable gall bladder in fetus: what to do?

Objective: This study aims to evaluate the rate of undetectable gall bladder in fetus during antenatal examinations and accompanying characteristics. Methods: A total of 2704 fetuses examined in the second trimester were separated into two groups according to the presence or lack of their gall bladders during the imaging. The differences among the groups were compared. Those failed to image were examined second time. If it was failed to image in the second examination, more advanced examinations were performed and the prognosis was evaluated. Results: Gall bladder was found in situ in 96.9% of the cases in the first examination and in 99.1% of the cases cumulatively in the second examination. The majority (90.5%) of the cases of whose gall bladder cannot be detected were between 15 and 18 weeks of their gestation. While imaging success was increasing as week of gestation increases, gall bladder was displayed in all cases which had no fetal anomaly after 22 weeks of gestation. While gall bladder could not be detected in 19.6% of the cases with fetal anomaly, a higher rate of fetal anomaly (22.6%) was observed in cases whose gall bladder could not be detected which was statistically significant (p<0.001). The lack of isolated gall bladder was determined in one of 3 cases who delivered and whose gall bladder could not be detected. Conclusion: Gall bladder should be seen during fetal examination until 22 weeks of gestation. Imaging is ensured usually by consecutive evaluations. The cases in the contrary condition should be evaluated in terms of fetal anomaly, if necessary, cystic fibrosis, biliary atresia and karyotype anomalies should be investigated.