Journal of Korean Society of Medical Ultrasound 1999;18(2): 125-129.
First Trimester Fetal Physiologic Midgut Herniation: Transvaginal Sonographic Findings.
Tae Hee Kwon, Yong Hyun Park
Department of Radiology, CHA Geneal Hospital, Pochon college of Medicine.
  Published online: January 1, 2001.
PURPOSE: To evaluate the sonographic features and appearance time of the physiologic midgut herniation early in pregnancy. MATERIALS and METHODS: Sonograms of 87 fetuses ranging from 7 to 13 weeks were obtained over a 2-month period. The presence or absence, the size and echogenecity of the physiologic midgut herniation were evaluated on each examination. Disappearance of the midgut herniation was confirmed on follow-up sonogram at 13-20 weeks, 3-12weeks after the first sonogram. The results were analyzed in terms of appearance or disappearance time of midgut herniation. RESULTS: In all cases of physiologic midgut herniation, an echogenic mass measuring 0.4-0.7cm was demonstrated within the base of the umbilical cord at its insertion into the fetal abdomen. This herniation was detected in 3/6 cases (50%) at 8 weeks, in 15/16 cases (94%) at 9 weeks, in 22/24 cases (92%) at 10 weeks and in 12/27 cases (44%) at 11 weeks gestation. None of the fetuses studied at 7 weeks and 12 weeks had a midgut herniation. CONCLUSION: Sonographic findings of a 0.4-0.7cm sized echogenic mass within the base of the umbilical cord which appears from 8weeks to 12weeks 'pregnancy represent physiologic midgut herniation in early pregnancy and should not be confused with pathologic ventral wall defect such as omphalocele or gastroschisis.
Keywords: Fetus abnormalities; Fetus gastrointestinal tract; Fetus US
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