OBJECTIVE: The objective was to evaluate the incidence of gastrointestinal 
abnormalities amongst those fetuses with antenatally diagnosed echogenic bowel 
(EB).
MATERIALS AND METHODS: A retrospective review of all cases delivered from April 
2002 to March 2003 with antenatally diagnosed EB was conducted. This was defined 
as bowel that appeared as echogenic as (if not greater than) the iliac bone on a 
real-time image. The postnatal outcomes with regard to gastrointestinal 
abnormalities, till their discharge, were noted.
RESULTS: Of the 13,941 patients delivered, there were 70 cases with antenatally 
diagnosed EB, giving an incidence of 70/13,941 or 0.50%. Of these, 6 defaulted 
follow-up and 1 had a mid-trimester termination of pregnancy at 21 weeks' 
gestation for social reasons. Of the remaining 63 cases with EB, 2 were 
stillbirths at 31 weeks and 35 weeks of gestation, respectively. Three fetuses 
(3/63 or 4.76%) were diagnosed with gastrointestinal abnormalities. Meconium 
plug syndrome was diagnosed postnatally in 2 cases, of which, 1 resolved with 
conservative management while the other required an emergency laparotomy. 
Intestinal atresia was diagnosed in the postmortem of one of the stillbirths. 
There was evidence of intrauterine growth retardation (IUGR) in both the 
stillbirth and the fetus that had required laparotomy. None of the 3 fetuses 
exhibited clinical features of aneuploidy.
CONCLUSION: As the quoted background risk for gastrointestinal pathology is 
0.23%, an increased incidence (4.76%) is observed in those fetuses found to have 
antenatal EB. It is possible that the presence of IUGR is associated with a 
worse prognosis. Further prospective studies are needed to verify this 
association.