Fetal intestinal dilatation and digestive tract abnormalities: an analysis of 94 cases from 16,090 deliveries in eastern Tianjin

Abstract Purpose This study aimed to investigate the association between structural abnormalities of the digestive system in newborns and prenatal ultrasound findings of fetal intestinal dilatation. Methods A retrospective analysis was conducted using clinical data from neonates with digestive tract abnormalities delivered at the Third Central Hospital of Tianjin between 1 January 2021 and 31 May 2025. Results A total of 27 neonates were diagnosed with structural abnormalities of the digestive tract. These included 17 cases of congenital anal stenosis, 2 cases of congenital anal atresia, 3 cases of congenital megacolon, 2 cases of intestinal atresia, 1 case of annular pancreas, 1 case of gastric duplication, and 1 case of duodenal web. Additionally, 67 cases were identified with functional digestive system disorders, comprising 3 cases of meconium plug syndrome and 6 cases of gastroesophageal reflux. The remaining cases, which lacked a clear aetiology, were successfully resolved following conservative medical management. No statistically significant difference was observed between the two groups in the rate of abnormal prenatal ultrasound findings or in the degree of intestinal dilatation. Furthermore, there were no significant differences in maternal age, parity, incidence of hypertension, diabetes, hypothyroidism, or in abnormalities related to amniotic fluid, umbilical cord, or placenta. Significant differences were identified in birth weight and birth length; however, no significant differences were found in head circumference, neutrophil count, lymphocyte count, haemoglobin level, platelet count, liver function tests, or calcium and phosphorus metabolism. Conclusion Structural abnormalities of the upper digestive tract in newborns may present earlier and be more readily detectable on prenatal ultrasound imaging. In contrast, structural abnormalities of the lower gastrointestinal tract may not exhibit clear anomalous features on prenatal ultrasound. Therefore, reliance solely on prenatal ultrasound examination for diagnostic investigation is not recommended. Clinicians should perform a timely differential diagnosis after birth based on clinical symptoms and signs to avoid delays in diagnosis and treatment.