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Nonvisualization of the fetal gallbladder by second‐trimester ultrasound scan: strategy of clinical management based on four examples
Author(s) -
Boughanim Mathias,
Benachi Alexandra,
Dreux Sophie,
Delahaye Sophie,
Muller Françoise
Publication year - 2008
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.1912
Subject(s) - gallbladder , medicine , biliary atresia , fetus , prenatal diagnosis , cystic duct , cystic fibrosis , atresia , agenesis , radiology , pregnancy , amniotic fluid , ultrasound , obstetrics , pathology , surgery , biology , genetics , transplantation , liver transplantation
Objective When the fetal gallbladder is not seen at ultrasound (US) scan, to propose a diagnostic method of differentiating fetuses who are healthy or have minor anomalies from fetuses with severe anomalies requiring intensive management. Method We present four clinical cases illustrating this variability, together with additional examinations: karyotyping, screening for cystic fibrosis mutations, amniotic fluid digestive enzyme activities. Results The four examples we present‐biliary duct atresia, biliary agenesis, gallbladder reveal at birth, and cystic fibrosis‐illustrate the difficulties of making both diagnosis and prognosis prenatally when the gallbladder is not visualized. Laboratory assays allowed prenatal management. Conclusion Failure to visualize the gallbladder prenatally may indicate fetal diseases of highly variable prognosis, but may also sometimes be followed by postnatal visualization in a child free of any disease. Prenatal management could help in defining diagnosis and prognosis. Copyright © 2008 John Wiley & Sons, Ltd.