J Korean Soc Med Ultrasound.  1999 Jun;18(2):125-129.

First Trimester Fetal Physiologic Midgut Herniation: Transvaginal Sonographic Findings

• Kwon TH
• Park YH

Abstract

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.

MeSH Terms

Abdomen
Female
Fetus
Follow-Up Studies
Gastroschisis
Hernia, Umbilical
Humans
Pregnancy
Pregnancy Trimester, First*
Ultrasonography*
Umbilical Cord