Materials and Methods
Fourteen fetuses without apparent abnormalities were selected as the control group. Thirteen fetuses diagnosed with isolated hyperechoic bowel, but without serious malformations and chromosome abnormalities were selected as the EB group from December 2018 to September 2019. At the same time, seven fetuses diagnosed with hyperechoic bowel and other abnormalities were selected as the C-EB group. Group C-EB Included one case with an isolated lung, one case with a persistent left superior vena cava and coronary sinus dilation, one case with a right subclavian artery vagal with renal pelvis separate, one case with a neck hemangioma, one case of a premature infant, one case with left hydronephrosis, and one case with right subventricular cyst.
The inclusion criteria for the control group were as follows: 1) singleton full-term newborn delivered via caesarean section; 2) fetal prenatal ultrasound showed no strong echoes of the intestinal tract, no other abnormalities, and the gestational age by ultrasound was consistent with the actual gestational age; 3) all prenatal data available; and 4) normal maternal menstrual pattern, good maternal physical health, no antibiotics used in the first 3 months of pregnancy, no maternal smoking, no maternal history of diabetes or heart disease, no abnormalities on maternal biochemical and Torch testing.
The inclusion criteria for the EB group were as follows: 1) according to the Slotnick and Abuhamad ultrasonographic grading system, all cases in this group were > grade 2 without any other abnormalities; and 2) the inclusion criteria were otherwise the same as the control group.
The inclusion criteria for the C-EB group were as follows:according to the Slotnick and Abuhamad ultrasonographic grading system, the patients in this group were > grade 2 with other abnormalities; and 2) the inclusion criteria were otherwise the same as the control group.
The exclusion criteria were as follows: 1) the mother had ingested a probiotic preparation within 1 month before delivery; 2) the newborn was fed milk before the fecal collection; and 3) the mother participated in another clinical trial at the same time.
The clinical data from the parturient were collected as follows: parturient age; gestational age; and mode of delivery. The clinical data from the infants were collected as follows: height; weight; gender; and Apgar scores at 1, 5, and 10 min.
AGE Voluson E8 and E10 Doppler ultrasound machines(Voluson E8 and E10,GE,Boston, Massachusetts,USA) were used to evaluate fetal growth, the amniotic fluid volume, placenta, and umbilical cord. Then, we evaluated the echo intensity of fetal intestines and iliac crest. Hyperechogenic bowel was diagnosed by two senior physicians at the same time. The echo intensity of the fetal intestines was the same as or stronger than that iliac bone on the same sonogram (Figure 1).