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The fetal esophagus: anatomical and physiological ultrasonographic characterization using a high‐resolution linear transducer

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Abstract:

Objective

To study the sonographic anatomy and physiology of the human fetal esophagus during the mid‐trimester of pregnancy using a high‐resolution linear transducer.

Methods

This was a prospective observational study of the fetal esophagus between 19 and 25 weeks' gestation. The study was performed in 60 consecutive fetuses, after a normal anatomy scan, using a 5–13‐MHz matrix array wide‐band transducer. During the examination the collapsed esophagus was first visualized, and followed by a 5‐min video recording in order to demonstrate luminal patency and peristaltic waves.

Results

Complete anatomical visualization of the esophagus was possible in 52 (86.7%) patients and at least partial visualization in 58 (96.7%) patients. Three different patterns of esophageal motility were observed: a simultaneous and short opening of the whole esophagus was found in 35 (58.3%) fetuses; a segmental, peristalsis‐like movement from the pharynx, through the mediastinum, and into the stomach was found in 18 (30%) fetuses; and in one fetus reflux‐like passage of solid contents from the stomach was observed. The mean time required for demonstration of esophageal patency was 96.1 (range, 10–300) s.

Conclusions

Demonstration of normal anatomy and physiological activity of the fetal esophagus is feasible using appropriate transducers. The most commonly observed pattern of esophageal motility in the mid‐trimester of pregnancy is the simultaneous relaxation of the upper and lower esophageal sphincters with concurrent opening of the esophageal lumen from the upper thorax to the stomach. Demonstration of a patent esophagus may be helpful in fetuses with suspected esophageal atresia. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.

Keywords: fetal anatomy; fetal esophagus; fetal physiology; ultrasound

Document Type: Research Article

DOI: http://dx.doi.org/10.1002/uog.1091

Affiliations: 1: Prenatal Diagnosis Unit, The Edith Wolfson Medical Center, Holon and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel 2: Pediatric Gastroenterology Unit, The Edith Wolfson Medical Center, Holon and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel 3: Maternal–Fetal Medicine Unit, Department of Obstetrics and Gynecology, Israel

Publication date: October 1, 2004

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