1. Non-visualization of the gallbladder on fetal ultrasound: Prenatal findings and postnatal outcome
Oya Demirci, Güher Bolat, Mucize Özdemir, Ayşenur Celayir
Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Perinatology Department

2. Case 26 years old primigravida woman.
At 22 weeks’ gestation on detailed examination
Hyperechogenic fetal bowel was seen.
The gallbladder could not be visualized.
Amniocentesis was performed at 23  weeks

3. Normal karyotype was established.
CFTR gene mutation was not detected.
Ƴ-glutamyl transpeptidase and intestinal alkaline phosphatase were investigated.
Normal development or bening gallbladder agenesis
Severe anomaly such as biliary atresia.

4. Amniotic fluid digestive enzyme activities
gamma-glutamyl transpeptidase (GGTP) value : At the 10 th percentile
Intestinal alkaline phosphatase : Low value.

5. 37 weeks, 2780 g female neonate
Normal clinical and biochemical findings
On postnatal ultrasound examination :
The small gallbladder
Normal bile duct and common hepatic duct

6. Conclusion Non-visualization of the fetal gallbladder Associated with:
Gallbladder agenesis
Biliary atresia
Cystic fibrosis
Chromosomal abnormalities

7. Genetic consultation
Amniocentesis for fetal karyotyping
Screening for a CFTR gen mutation
Analysis of digestive enzymes
GGTP and intestinal alkaline phosphatase

8. Before 22 weeks' gestation
Low amniotic fluid digestive enzyme activities →Biliary atresia
After 22 weeks’ gestation
Low amniotic fluid digestive enzyme activities →Physiological

9. Result Our case, Low intestinal alkaline phosphatase level
Normal bile duct, common hepatic duct
This result may be due to Amniosentesis after 22 weeks’ gestation