OBJECTIVE: To assess the relationship between intra-amniotic bleeding and fetal 
echogenic bowel.
METHODS: Comprehensive fetal ultrasound examinations were done before and 12 
hours after fetal transfusions. Follow-up ultrasound examinations were done 
weekly in 28 fetuses with intra-amniotic bleeding. Hyperechogenic bowel was 
diagnosed when the echogenicity of fetal bowel was similar to that of bone. 
Postpuncture bleeding was identified when a stream of echogenic material from 
the cord into the amniotic space was seen, lasting at least 60 seconds.
RESULTS: None of the fetuses had echogenic bowel before initial transfusions. 
Intra-amniotic bleeding was followed by bowel echogenicity in seven of 28 
fetuses within the first 12 hours after bleeding episodes. Echogenic bowel 
remained in five fetuses 2 weeks after the bleeding episodes. In three fetuses, 
echogenic bowel was still seen 4 weeks later.
CONCLUSION: Intra-amniotic bleeding can lead to echogenic bowel.