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Are Intracardiac Echogenic Foci Markers of Congenital Heart Disease in the Fetus With Chromosomal Abnormalities?

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, Maine USA.

Address correspondence and reprint requests to Joseph R. Wax, MD, MMC Ob/Gyn Associates, 887 Congress St, Suite 200, Portland, ME 04102. E-mail: waxj{at}mmc.org.

Objective. To determine whether intracardiac echogenic foci (ICEF) are markers of congenital heart disease (CHD) in fetuses with chromosomal abnormalities. Methods. We identified all fetuses with chromosomal abnormalities undergoing targeted sonography at 17 weeks’ to 21 weeks 6 days’ gestation in a single perinatal center from January 1, 1994, to June 30, 2003. Offspring with and without CHD were compared for the presence or absence of ICEF. Results. Two (8%) of 25 fetuses with ICEF had CHD versus 38 (33.3%) of 114 fetuses without ICEF (P = .006). Similarly, 1 (5.5%) of 18 fetuses with trisomy 21 and ICEF had CHD compared with 16 (37.2%) of 43 fetuses with trisomy 21 without ICEF (P = .009). Conclusions. Intracardiac echogenic foci in fetuses with chromosomal abnormalities, including those with trisomy 21, are not useful markers for CHD.

Key Words: congenital heart disease • Down syndrome • intracardiac echogenic focus

Abbreviations: CHD, congenital heart disease • CI, confidence interval • ICEF, intracardiac echogenic foci • OR, odds ratio