IMR Press / CEOG / Volume 50 / Issue 6 / DOI: 10.31083/j.ceog5006119
Open Access Original Research
Feasiblity Study on the Longitudinal Section of the Fetal Esophagus by Prenatal Ultrasound between 21 and 23 Gestational Weeks
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1 Department of Ultrasonography, Shenzhen Hospital of Southern Medical University, 518101 Shenzhen, Guangdong, China
*Correspondence: yshzhu@fmmu.edu.cn (Yongsheng Zhu)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2023, 50(6), 119; https://doi.org/10.31083/j.ceog5006119
Submitted: 10 January 2023 | Revised: 7 February 2023 | Accepted: 16 February 2023 | Published: 30 May 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Prenatal esophageal atresia (EA) diagnosis may improve outcomes by optimizing prenatal and postnatal care. This study evaluated the feasibility of direct antenatal visualization of normal longitudinal esophageal sections using two-dimensional ultrasound between 21 and 23 gestational weeks. Methods: A detailed prenatal anatomic survey was performed, followed by dedicated esophageal imaging. The latter was performed as follows: coronal sections of the thoracic aorta were obtained; the sound beam was then moved ventrally; and strip-shaped high echoes with three or more hyperechoic layers were identified as the esophagus. Images showing the longest esophageal segment were used to measure the esophageal length and angle (between the thoracic aorta and esophagus). Results: Longitudinal esophageal sections were visualized in 94.0% (n = 205/218) of patients. The visualization rates between fetuses in different positions were statistically significant (p < 0.05). Two tubular patterns of longitudinal fetal esophagus sections were observed when collapsed on ultrasound: a tubular structure composed of three hyperechoic layers (40.4%, 88/218); and a tube composed of multilayered hyperechoic structures (59.6%, 130/218). Swallowing actions were observed in 28 cases (12.8%, 28/218). The fetal esophagus was fluid-filled and exhibited an appearance similar to a tram-track sign. The time taken to visualize the longitudinal esophageal section was 21.3 ± 13.1 sec (range 3–60 sec). Conclusions: Direct antenatal visualization of a normal fetal esophagus is feasible, and recommended when suspecting EA on routine fetal ultrasound, to improve diagnostic specificity.

Keywords
longitudinal section
fetal esophagus
prenatal ultrasound
Funding
JCYJ20180306174225855/Fund of Shenzhen Science and Technology Innovation Commission
Figures
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