EFSUMB EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY ‘Building a European Ultrasound Community’ Young Investigator’s Award EUROSON 2016 Leipzig, Germany 28 October 14.00 – 15.30
7 minutes each for presentation plus 2 minutes discussion
Echogenic Material in fetal gallbladder: Is there any association with dietary Na+ and Ca++ uptake? Gokce Akgunduz Bartın State Hospital, Turkey
ABSTRACT Purpose To determine the prevalance of echogenic material in the fetal gallbladder, to analyse its association with perinatal factors such as maternal dietary Na, Ca ingestion and to present its sonographic findings and postnatal outcomes. Methods We performed a prospective study with 5893 pregnant patients. Maternal and umbilical cord blood were taken after delivery in examined group and Na, Ca, PTH, calcitonin, vit D levels in both maternal and cord blood were determined. All of the placentas were sent for pathological examination. Perinatal data (antibiotic usage, maternal diseases, amount of dietary Na/Ca uptake) was obtained from all of the patients. Postnatal ultrasonography was performed in identified cases Results There was no echogenic material in fetal gallbladder before 29 weeks. In the subgroup of 1983 fetuses (29-42 gestational weeks), 13 fetuses were found to have echogenic contents in gallbladder with a prevalance of 0.6%. It was shown that all of the examined group was drinking the same water, a kind of well water. The analyses of the drinking water revealed a relatively higher Na+ ratio than the ordinary drinking waters ( Ca++ level: 16 mg/L, and Na: 7.043 mg/L). Postnatal follow-up was carried out in all of the examined group and the echogenic material in the gallbladder was resolved in all of them within one month. Conclusion Na+/ Ca++ exhanger which is found in plasma membrane of hepatocytes and placenta are mainly responser of Ca++ extrusion, which is a prolithogenic factor. Therefore it may be postulated that increased Na+ uptake by drinking water causes Ca++ efflux to fetal gallbladder by Na+/Ca++ channels. Further experimental studies may reveal the exact mechanism of fetal gallbladder sludge/stone formation in fetuses with excess maternal intake of Na.