Hi, I have gone through your question and understand your concerns. Sludge in the fetal gallery bladder seen antenatally on ultrasound is due to collection of calcium, bilirubin and cholesterol in the fetal gall bladder due to various causes like: 1. Gall bladder and biliary tract anomalies 2. Chromosomal anomalies, especially Down syndrome 3. Cardiac anomalies, 4. Placental hematoma or haemorrhage ,6. Maternal narcotic abuse, especially methadone. I presume that all these must have been ruled out in your case. Usually most neonates have spontaneous passage of sludge with postnatal hydration, and have good prognosis. Karyotype of the baby should be done, if not done earlier, to rule out any chromosomal anomaly if present. Hope you found the answer helpful. Wishing you good health. Regards, Dr Deepti verma