Echogenic fetal bowel and calcified meconium in a fetus with trisomy 21

Echogenic fetal bowel is associated with an increased risk of adverse fetal outcome, including chromosomal abnormalities, intrauterine growth retardation, cystic fibrosis, intrauterine infections, and other fetal abnormalities. A pathologic correlation of a case of echogenic fatal bowel detected in a fetus with trisotomy 21 who died at two days of age is presented. Not all cases of echogenic fetal bowel lead to calcification, but in fetuses with Down syndrome, especially in cases in which echogenicity persists beyond the second trimester, calcification of meconium should be considered a cause when evaluating echogenic fetal bowel and increased abdominal echogenicity in the perinatal period.