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Why has the fetal stomach not been detected in my case?

Dr Ashok Khurana
Director, Genitourinary and Vascular Ultrasound,
The Ultrasound Lab,
New Delhi

Q: I am 22 years old. I have now had 7 anomaly scans and I am 27 weeks pregnant. The doctor has still not been able to find the fetal stomach. Nobody seems to be explaining to me the reason. I have been told that there is a problem and my baby will undergo surgery when he is born and that I will have to deliver in a hospital with a special care unit. However, they are still unforthcoming with details saying that I have to wait for an appointment with another consultant. I understand that this is a hard case to comment on, but I want more information on this. Where should I go for information? If I know what the possible problems might be, at least I will be able to prepare myself better. Please advise.

A:Failure to visualise the fetal stomach on repeated scanning indicates that the stomach does not fill or is not in a normal location. If it is not in its normal location then it is usually in the chest where it can be located with a careful ultrasound. The other causes of non-filling are problems of swallowing such as cleft lip and palate, brain abnormalities, failure of formation of the foodpipe and lumps in the babys neck. Many of these can be assessed on a careful ultrasound and with 3D/4D ultrasound. The outlook depends on the cause and its surgical correctibility and on associated abnormalities. Often, the condition is associated with increased amounts of fluid surrounding the baby and this may predispose to a premature delivery. Prematurity has a negative influence on the final outcome. A fetal medicine specialist and a paediatric surgeon may give more information after studying the reports.