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Nonvisualization of fetal gallbladder increases the risk of cystic fibrosis

Authors


  • Funding sources: This study was supported by a grant from the French Ministry of Health (PHRC 2007 ‘Evolution de l'Épidémiologie Génétique de la Mucoviscidose dans le Grand Ouest de la France’). The sponsor had no role in the study.
  • Conflict of interests: None declared

Claude Férec.

E-mail: claude.ferec@univ-brest.fr

ABSTRACT

Objective

The aim of our study is to evaluate the prevalence of cystic fibrosis (CF) in fetuses referred for genetic testing because of ultrasonographic sign (nonvisualized fetal gallbladder – NVFGB).

Method

We reviewed the results of CFTR gene analysis over the period 2002 to 2009 in all consecutive cases referred because of NVFGB in Western France. We correlated these data with the presence of a more classical ultrasonographic finding (fetal echogenic bowel – FEB).

Results

Cystic fibrosis was diagnosed in 5 of the 37 fetuses with NVFGB (13.5%, 95% confidence interval (CI): [2.5%; 24.5%]) and in only 9 of the 229 other cases referred because of FEB (3.9%, 95% CI: [3.2%; 14.7%]). In our series, all CF-affected fetuses with NVFGB also had FEB. The risk of CF was 11.6-fold higher in fetuses with both indications (NVFGB + FEB) than in fetuses with isolated FEB (45.5% vs 3.9%, RR = 11.6, 95% CI: [4.7%; 28.8%], p = 0.0001). We also estimated that the residual risk of CF was less than 1 in 68 (1.5%) when a single mutation was identified in the fetus by our molecular protocol.

Conclusion

Ultrasonographic evidence of NVFGB is an additional risk factor for CF in cases with FEB. © 2011 John Wiley & Sons, Ltd.

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