Echogenic bowel

What is echogenic bowel?

An increase in the brightness of the baby’s bowel on ultrasound scan. Usually picked up at the 20-week scan but can be noticed later in pregnancy.

What are the signs of echogenic bowel and how is it diagnosed?

Brightness of the bowel is diagnosed on ultrasound but is subjective and can be over diagnosed if the settings are not optimised. Echogenic bowel occurs in about 1% of fetuses.

What causes echogenic bowel?

In over 90% cases it is a variation of normal and has no impact on the baby’s health. Other causes include:

  • Bleeding in pregnancy – if the baby swallows blood it can show up on the scan. This is not harmful to the baby and is likely to resolve with time. An invasive procedure such as amniocentesis can also cause bleeding which the baby can ingest
  • Cystic fibrosis – an inherited condition that affects the lungs and bowel. It can cause thicker secretions in the baby’s bowel which show up on the scan. Found in approximately 2% of babies with echogenic bowel
  • Chromosomal differences – approximately 3% of babies with echogenic bowel have a chromosomal difference. The most common is Trisomy 21 (Down’s syndrome) but there are others
  • Bowel obstruction – if the bowel has twisted or has a narrowing this can show up as echogenic bowel
  • Placental function – some babies may have reduced blood flowing through their placenta. This can affect their growth and can reduce blood supply to their bowel, causing it to appear echogenic

Are there any associated differences or conditions?

Echogenic bowel can be associated with other cardiovascular, urogenital, gastrointestinal and cerebral differences so a detailed anatomy scan is necessary . There is an association with chromosomal abnormality as described above.

Are any other investigations required?

Patients are routinely offered screening in the first trimester for the common trisomies T21, 13, 18. If this has not happened, you may be offered NIPT (another screening blood test).

If there are other structural differences you may be offered invasive testing (amniocentesis) to check the baby’s genetics

A blood test will check for infection and Cystic Fibrosis carrier status. Your partner may also be offered a blood test.

How is echogenic bowel monitored during pregnancy and what will this mean for delivery?

You will likely have ongoing scans for growth and to monitor the status of the bowel. Delivery often depends on the underlying cause but it is unlikely to affect delivery on its own.

What is the long-term outcome and will this happen again?

Both will be dependent on the underlying cause