Fetal Stomach Size Assessment and Associated Risks

Ultrasound Evaluation and Diagnostic Approach

Transabdominal ultrasound is the primary imaging modality for evaluating fetal stomach size, performed as part of the detailed fetal anatomic examination, according to the American College of Radiology 1, 2
A detailed anatomic survey should be performed at 18-22 weeks as part of routine screening, with the stomach being one of the required structures to visualize, as recommended by the American College of Radiology 3, 4

Diagnostic testing with chromosomal microarray analysis should be offered when fetal growth restriction is detected with malformations or when unexplained isolated growth restriction is diagnosed before 32 weeks, according to the American College of Obstetricians and Gynecologists 5
Gastrointestinal anomalies, including esophageal atresia, tracheoesophageal fistula, duodenal atresia, and gastroschisis, are common associations with fetal stomach abnormalities, as noted by the American College of Radiology 3
Approximately 10% of fetuses with growth restriction have congenital anomalies, according to the American College of Radiology 6
Amniotic fluid volume assessment is critical in all cases of suspected stomach abnormalities, as emphasized by the American Heart Association 7, 8

Perform detailed fetal anatomic examination to identify associated structural abnormalities, and assess amniotic fluid volume, as recommended by the American College of Obstetricians and Gynecologists and the American College of Radiology 3, 5
Offer genetic testing with chromosomal microarray analysis, especially if detected before 32 weeks or if other abnormalities are present, according to the American College of Obstetricians and Gynecologists 5
Serial ultrasound examinations every 2-4 weeks to monitor stomach size, growth parameters, and amniotic fluid, as recommended by the American College of Obstetricians and Gynecologists and the American Heart Association 5, 8