CLINICAL IMPLICATIONS AND OUTCOME OF NON‐VISUALIZATION OF FETAL GALLBLADDER: A RETROSPECTIVE COHORT STUDY

Objectives: Non-visualization of the fetal gallbladder (NVFGB) is a rare prenatal ultrasound finding associated with a wide spectrum of outcomes, ranging from benign conditions to severe hepatobiliary and genetic disorders. This study evaluated the prenatal characteristics, prognostic significance of associated anomalies, and postnatal outcomes of fetuses diagnosed with NVFGB.Material and Methods: This retrospective cohort study included 25 pregnancies diagnosed with NVFGB between November 2020 and May 2025. Cases were categorized as isolated or non-isolated according to additional structural anomalies. Prenatal ultrasound findings, invasive prenatal testing and genetic analyses, and postnatal outcomes were retrospectively reviewed using descriptive statistical methods.Results: Isolated NVFGB was identified in 19 cases (76%), whereas six cases (24%) were non-isolated. Postnatal gallbladder visualization occurred in 12 (63%) of 19 isolated cases, and gallbladder agenesis was confirmed in seven (37%). One isolated case was associated with cystic fibrosis and another with a 22q11.2 microdeletion. In the non-isolated group, pregnancy termination was performed in two cases (33%), and postnatal gallbladder visualization occurred in two (33%). Two situs anomalies, one left atrial isomerism and one situs inversus totalis, were observed among fetuses with non–isolated NVFGB.Conclusions: Isolated NVFGB should prompt detailed ultrasound evaluation and consideration of genetic counseling, cystic fibrosis, and biliary atresia. Patients should be informed about likely postnatal outcomes, including postnatal gallbladder visualization or gallbladder agenesis. Non-visualization NVFGB is associated with poorer outcomes, underscoring the prognostic importance of associated anomalies for prenatal counseling and clinical decision-making.