I'm 20 weeks pregnant with twins and level 2 scan

Patient

Q: I'm 20 weeks pregnant with twins and level 2 scan showed "persistent dilated stomach for both fetuses"
Radiologist Doctor rechecked after some time and both the fetuses has compressed stomach within limit but at one point it was enlarged per gestation age. Does this always lead to bad outcome? I'm hoping to hear that this issue gets resolved on its own. Please help . This is a precious pregnancy through IVF and hoping all is good.

Doctor

A:   Hello,
Thanks for the query.

Persistent dilated bowel is a soft marker for fetal aneuploiodies. That means it is one of the marker for chromosomal anomalies in the fetus. However finding them in isolation with no other markers significant of an anomaly on ultrasound is not of importance. Since the persistence had disappeared now there is nothing to worry. However the fetuses should be treated as for high risk and pregnancy to be well monitored. Serial ultrasounds for growth and any markers for aneuploiodies have to be done. Any suspicion, opt for amniocentesis or cordocentesis though may be a late option. Consult your gynecologist and discuss regarding the same. Other soft markers include nasal translucency, echo genie bowel, dilated bowel loops, ventriculomegaly, single umbilical artery, cystic hygrometer, etc. Presence of only one marker is not definitive of anything and do not warrant termination. However, serial monitoring is necessary with ultrasound and biochemical tests like quadruple marker test. All put together we can quantify the risk involved in present pregnancy with such a change in ultrasound.

Hope this helps
Regards

Comments / Follow Ups

Patient: Thank you so much for your response. It is actually dilated stomach and not dilated bowel.All other marker tests like NT scan, double marker, quad screen are within normal range and low risks. Yesterday when I went for the scan the radiologist found everything else normal except the stomach was enlarged and she asked me to come back again today and today the first time she mentioned that it's still on bigger side and then checked me again after 20 mins and said that one of th fetus stomach has collapsed to normal range but for baby B it was was still big and then after 20-30 mins even the second baby's stomach also collapsed. She said normal range for 20 week is 11% and both babies were at 23% initially and then after collapsing the stomach was down to 9% and 12% so well within range but because it was elevated at one point so she said it could be a problem. Enlarged Stomach measurement was 19*14*23 which is more as per gestation age.
I'm even attaching my screen files for you to check please..
We already lost our first child 2 years back coz of gut malformation and now so heartbroken on seeing this enlarged stomach issue.
All our genetic and chromosome and torch tests were normal.
Trying to find a high risk Doctor but for now looking for some help online to figure of this is something which could resolve on its own?
Amniotic fluid level was all normal so could be it that baby is just big in size or has swallowed more fluid?
How could a similar issue be with both then twins?
Doctor: Hello. Thanks for the query
We understand your concern and apprehension as a parent and having lost a previous child for a similar reason, it would be very difficult to deal with it. However there is nothing to worry here as it is an isolated finding and all other markers are normal. The presence of stomach enlargement in isolation does not mean anything and is not an indication for termination. However if it is associated with duodenal atresia then there could be a chance of aneuploiodies or trisomy.
Kindly consult a genetic counselor personally before taking any call on this. An isolated stomach enlargement on second trimester scan will not hold good for any decisions or predict outcomes
Hope this helps
Regards

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