Little shiny dots in the fetal heart. Should we be concerned?

Kiran Hilal, Imrana Masroor, Zainab Hussain, Anam Khan


Objective:   To evaluate the impact of fetal intracardiac echogenic focus (EIF) in relation to fetal outcome.

Methodology: A descriptive cross-sectional study conducted at radiology department of Aga Khan University Hospital (from January 2009 till January 2012). All fetuses found to have intracardiac echogenic focus during 2nd trimester anomaly scan were included in the study. The outcome was defined as echocardiography or post-delivery notes from confidential files.

 Results: A total of 8000 fetuses were evaluated in 2nd trimester with ultrasound during the study period. In 138 fetuses echogenic intracardiac focus was identified. In 125 fetuses this was an isolated finding and in 13(9.5 %) fetuses this was associated with other soft markers such as pyelectasis or choroid plexus cyst.

A total number of 38 patients had echocardiography. Echo findings were abnormal in 10 (7.2%) fetuses. Karyotyping was performed only in two fetuses after birth because of clinical suspicious of aneuploidy and results were normal. All fetuses were reported to be normal at birth.

 Conclusion:    All fetuses with isolated intracardiac echogenic focus or echogenic focus with other soft markers were reported as normal in their post natal period. Our results suggest that the presence of EIF has no significant association with abnormal fetal out come. Considering abnormal echocardiography findings in 6.5 % patients, we emphasize for further future studies to evaluate the hemodynamic significance of echogenic focus in fetal heart.

 Keywords:  Echogenic intra cardiac focus, postnatal fetal outcome, prenatal ultrasound.

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