The incidence of different fetal outcomes for prenatal ultrasound screening in non-visualization of the fetal gallbladder: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

XIA Qingqing ^1,2 , WANG Yue ¹ ,  LIU Li ¹

1. Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, 518035, P.R.China;
2. Shantou University Medical College, Shantou, 515063, P.R.China;

Corresponding author：

LIU Li, Email: liuli126126@126.com

Keywords：

Fetal; Non-visualization of the gallbladder; Prenatal diagnosis; Perinatal outcome; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.201906002

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objectives To systematically review the incidence of various outcomes in non-visualization of the fetal gallbladder (NVFGB) fetuses by prenatal ultrasonography.Methods PubMed, The Cochrane Library, Elsevier, ClinicalKey, CBM, CNKI and WanFang Data databases were electronically searched to collect studies on NVFGB fetuses by prenatal ultrasonography from January 1990 to March 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using R 3.5.2 software.Results A total of 9 studies were included. The results of meta-analysis showed that: the incidence of fetal biliary atresia was 1.0%, with 2.0% in the isolated and 3.0% in the non-isolated. The incidence of cystic fibrosis was 6.0%, with 2.0% in the isolated and 9.0% in the non-isolated. The incidence of chromosomal abnormality was 5.0%, and 31.0% in non-isolated. The incidence of other malformations other than those described above was 13.0%, with 44.0% in the non-isolated. The incidence of gallbladder agenesis or absent gallbladder was 22.0%, with 28.0% in the isolated. The incidence of later visualization of gallbladder and normal fetal outcomes was 53.0%, with 63.0% in the isolated.Conclusions Current evidence shows that most non-visualization of the fetal gallbladder can identify the presence of gallbladder during late gestation or neonatal ultrasonography. The exactly isolated non-visualization of the fetal gallbladder is highly related to the fetal gallbladder agenesis or the absence of the gallbladder. The non-isolated non-visualization of the fetal gallbladder is highly related to biliary atresia, cystic fibrosis (particularly in the presence of fetal bowel echogenicity), and chromosomal abnormalities (especially chromosome aneuploidy).

Citation： XIA Qingqing, WANG Yue, LIU Li. The incidence of different fetal outcomes for prenatal ultrasound screening in non-visualization of the fetal gallbladder: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(12): 1423-1429. doi: 10.7507/1672-2531.201906002 Copy

1.	Bardin R, Ashwal E, Davidov B, et al. Nonvisualization of the fetal gallbladder: can levels of gamma-glutamyl transpeptidase in amniotic fluid predict fetal prognosis? Fetal Diagn Ther, 2016, 39(1): 50-55.
2.	Ochshorn Y, Rosner G, Barel D, et al. Clinical evaluation of isolated nonvisualized fetal gallbladder. Prenat Diagn, 2007, 27(8): 699-703.
3.	Boughanim M, Benachi A, Dreux S, et al. Nonvisualization of the fetal gallbladder by second-trimester ultrasound scan: strategy of clinical management based on four examples. Prenat Diagn, 2008, 28(1): 46-48.
4.	Shen O, Rabinowitz R, Yagel S, et al. Absent gallbladder on fetal ultrasound: prenatal findings and postnatal outcome. Ultrasound Obstet Gynecol, 2011, 37(6): 673-677.
5.	Rostom A, Dube C, Cranney A, et al. Celiac disease. evidence report/technology assessment No. 104. AHRQ Publication No. 04-E029-2. Rockville, MD: Agency for Healthcare Research and Quality; 2004.
6.	Dreux S, Boughanim M, Lepinard C, et al. Relationship of non-visualization of the fetal gallbladder and amniotic fluid digestive enzymes analysis to outcome. Prenat Diagn, 2012, 32(5): 423-426.
7.	Sagi-Dain L, Singer A, Hadid Y, et al. Non-visualization of fetal gallbladder in microarray era - a retrospective cohort study and review of the literature. J Matern Fetal Neonatal Med, 2019, 32(16): 2643-2648.
8.	Shraga B, Zimmer EZ, Bronshtein M. Nonvisualization of the fetal gallbladder in early pregnancy: comparison with clinical outcome. Radiology, 2002, 224(2): 379-382.
9.	Duguépéroux I, Scotet V, Audrézet MP, et al. Nonvisualization of fetal gallbladder increases the risk of cystic fibrosis. Prenat Diagn, 2012, 32(1): 21-28.
10.	张波, 杨太珠, 朱琦, 等. 超声诊断的胎儿孤立性胆囊未显示的临床预后. 中国临床医学影像杂志, 2018, 29(2): 109-111.
11.	彭旭红. 超声诊断胎儿胆囊未见的临床评价及预后. 中南医学科学杂志, 2012, 40(4): 420-423.
12.	Petersen C. Pathogenesis and treatment opportunities for biliary atresia. Clin Liver Dis, 2006, 10(1): 73-88.
13.	王银, 李胜利, 陈琮瑛, 等. 胎儿胆囊异常的产前超声诊断及意义. 中华医学超声杂志 (电子版), 2012, 9(5): 433-438.
14.	Chalouhi GE, Muller F, Dreux S, et al. Prenatal non-visualization of fetal gallbladder: beware of biliary atresia! Ultrasound Obstet Gynecol, 2011, 38(2): 237-238.
15.	Kilgore A, Mack CL. Update on investigations pertaining to the pathogenesis of biliary atresia. Pediatr Surg Int, 2017, 33(12): 1233-1241.
16.	Serinet MO, Wildhaber BE, Broué P, et al. Impact of age at Kasai operation on its results in late childhood and adolescence: a rational basis for biliary atresia screening. Pediatrics, 2009, 123(5): 1280-1286.
17.	Lakshminarayanan B, Davenport M. Biliary atresia: a comprehensive review. J Autoimmun, 2016, 73: 1-9.
18.	Bergougnoux A, Jouannic JM, Verneau F, et al. Isolated nonvisualization of the fetal gallbladder should be considered for the prenatal diagnosis of cystic fibrosis. Fetal Diagn Ther, 2019, 45(5): 312-316.
19.	Cutting GR. Cystic fibrosis genetics: from molecular understanding to clinical application. Nat Rev Genet, 2015, 16(1): 45-56.
20.	Francine BN, Romano C, Anne I, et al. Cystic fibrosis: advancing along the continuum. J Pediatr Health Care, 2019, 33(3): 242-254.
21.	Antunovic SS, Lukac M, Vujovic D. Longitudinal cystic fibrosis care. Clin Pharmacol Ther, 2013, 93(1): 86-97.
22.	Brennan ML, Schrijver I. Cystic fibrosis: a review of associated phenotypes, use of molecular diagnostic approaches, genetic characteristics, progress, and dilemmas. J Mol Diagn, 2016, 18(1): 3-14.
23.	Pipia I, Kenchadze G, Demetrashvili Z, et al. Gallbladder agenesis: a case report and review of the literature. Int J Surg Case Rep, 2018, 53: 235-237.
24.	Koukoura O, Kelesidou V, Delianidou M, et al. Prenatal sonographic diagnosis of biliary tract malformations. J Clin Ultrasound, 2019, 47(5): 292-297.
25.	di Pasquo E, Kuleva M, Rousseau A, et al. Non-visualization of fetal gallbladder (NVFGB) by ultrasound in second trimester of pregnancy: a systematic review of the literature on postnatal outcome. Ultrasound Obstet Gynecol, 2019, 54(5): 582-588.

1. Bardin R, Ashwal E, Davidov B, et al. Nonvisualization of the fetal gallbladder: can levels of gamma-glutamyl transpeptidase in amniotic fluid predict fetal prognosis? Fetal Diagn Ther, 2016, 39(1): 50-55.
2. Ochshorn Y, Rosner G, Barel D, et al. Clinical evaluation of isolated nonvisualized fetal gallbladder. Prenat Diagn, 2007, 27(8): 699-703.
3. Boughanim M, Benachi A, Dreux S, et al. Nonvisualization of the fetal gallbladder by second-trimester ultrasound scan: strategy of clinical management based on four examples. Prenat Diagn, 2008, 28(1): 46-48.
4. Shen O, Rabinowitz R, Yagel S, et al. Absent gallbladder on fetal ultrasound: prenatal findings and postnatal outcome. Ultrasound Obstet Gynecol, 2011, 37(6): 673-677.
5. Rostom A, Dube C, Cranney A, et al. Celiac disease. evidence report/technology assessment No. 104. AHRQ Publication No. 04-E029-2. Rockville, MD: Agency for Healthcare Research and Quality; 2004.
6. Dreux S, Boughanim M, Lepinard C, et al. Relationship of non-visualization of the fetal gallbladder and amniotic fluid digestive enzymes analysis to outcome. Prenat Diagn, 2012, 32(5): 423-426.
7. Sagi-Dain L, Singer A, Hadid Y, et al. Non-visualization of fetal gallbladder in microarray era - a retrospective cohort study and review of the literature. J Matern Fetal Neonatal Med, 2019, 32(16): 2643-2648.
8. Shraga B, Zimmer EZ, Bronshtein M. Nonvisualization of the fetal gallbladder in early pregnancy: comparison with clinical outcome. Radiology, 2002, 224(2): 379-382.
9. Duguépéroux I, Scotet V, Audrézet MP, et al. Nonvisualization of fetal gallbladder increases the risk of cystic fibrosis. Prenat Diagn, 2012, 32(1): 21-28.
10. 张波, 杨太珠, 朱琦, 等. 超声诊断的胎儿孤立性胆囊未显示的临床预后. 中国临床医学影像杂志, 2018, 29(2): 109-111.
11. 彭旭红. 超声诊断胎儿胆囊未见的临床评价及预后. 中南医学科学杂志, 2012, 40(4): 420-423.
12. Petersen C. Pathogenesis and treatment opportunities for biliary atresia. Clin Liver Dis, 2006, 10(1): 73-88.
13. 王银, 李胜利, 陈琮瑛, 等. 胎儿胆囊异常的产前超声诊断及意义. 中华医学超声杂志 (电子版), 2012, 9(5): 433-438.
14. Chalouhi GE, Muller F, Dreux S, et al. Prenatal non-visualization of fetal gallbladder: beware of biliary atresia! Ultrasound Obstet Gynecol, 2011, 38(2): 237-238.
15. Kilgore A, Mack CL. Update on investigations pertaining to the pathogenesis of biliary atresia. Pediatr Surg Int, 2017, 33(12): 1233-1241.
16. Serinet MO, Wildhaber BE, Broué P, et al. Impact of age at Kasai operation on its results in late childhood and adolescence: a rational basis for biliary atresia screening. Pediatrics, 2009, 123(5): 1280-1286.
17. Lakshminarayanan B, Davenport M. Biliary atresia: a comprehensive review. J Autoimmun, 2016, 73: 1-9.
18. Bergougnoux A, Jouannic JM, Verneau F, et al. Isolated nonvisualization of the fetal gallbladder should be considered for the prenatal diagnosis of cystic fibrosis. Fetal Diagn Ther, 2019, 45(5): 312-316.
19. Cutting GR. Cystic fibrosis genetics: from molecular understanding to clinical application. Nat Rev Genet, 2015, 16(1): 45-56.
20. Francine BN, Romano C, Anne I, et al. Cystic fibrosis: advancing along the continuum. J Pediatr Health Care, 2019, 33(3): 242-254.
21. Antunovic SS, Lukac M, Vujovic D. Longitudinal cystic fibrosis care. Clin Pharmacol Ther, 2013, 93(1): 86-97.
22. Brennan ML, Schrijver I. Cystic fibrosis: a review of associated phenotypes, use of molecular diagnostic approaches, genetic characteristics, progress, and dilemmas. J Mol Diagn, 2016, 18(1): 3-14.
23. Pipia I, Kenchadze G, Demetrashvili Z, et al. Gallbladder agenesis: a case report and review of the literature. Int J Surg Case Rep, 2018, 53: 235-237.
24. Koukoura O, Kelesidou V, Delianidou M, et al. Prenatal sonographic diagnosis of biliary tract malformations. J Clin Ultrasound, 2019, 47(5): 292-297.
25. di Pasquo E, Kuleva M, Rousseau A, et al. Non-visualization of fetal gallbladder (NVFGB) by ultrasound in second trimester of pregnancy: a systematic review of the literature on postnatal outcome. Ultrasound Obstet Gynecol, 2019, 54(5): 582-588.

Previous Article
The economic burden of echinococcosis in China: a systematic review
Next Article
Genetic loci in the NF-κB pathway and lung cancer susceptibility: a meta-analysis

Chinese Journal of Evidence-Based Medicine

The incidence of different fetal outcomes for prenatal ultrasound screening in non-visualization of the fetal gallbladder: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content