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Hurt L, Uzun O, Morris S, Bethel J, Evans A, Seaborne M, Daniel R, Brophy S, Paranjothy S. Childhood Outcomes in Children with and without Cardiac Echogenic Foci: An Electronic Birth Cohort Study in Wales, UK. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1233. [PMID: 37508730 PMCID: PMC10378422 DOI: 10.3390/children10071233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/07/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023]
Abstract
There is uncertainty about outcomes associated with cardiac echogenic foci (CEF) seen at the midtrimester ultrasound scan because of limited population-based follow-up data. This can lead to unnecessary invasive testing and significant parental anxiety. We analysed data from a cohort study, The Welsh Study of Mothers and Babies, to examine whether children with CEF had more adverse outcomes during childhood compared with children without CEF. Children born between 1 January 2009 and 31 December 2011 were followed until 31 January 2018, migration out of Wales, or death. The primary outcome was cardiac hospital admissions, defined a priori by an expert steering group. Secondary outcomes included congenital cardiac anomalies, and hospital admissions for other causes. There was no evidence of an association between isolated CEF and cardiac hospital admissions (hazard ratio 0.87, 95% confidence interval [CI] 0.33-2.25, p value 0.768), or with congenital cardiac anomalies. There was a small increased risk of a respiratory admission with isolated CEF (hazard ratio 1.27, 95% CI 1.04-1.54, p value 0.020). Further research is needed on features of CEF, such as location or number, to fully understand the clinical significance of these findings.
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Affiliation(s)
- Lisa Hurt
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK; (J.B.); (R.D.)
| | - Orhan Uzun
- University Hospital of Wales, Cardiff and Vale University Health Board, Heath Park Way, Cardiff CF14 4XW, UK; (O.U.)
| | - Susan Morris
- University Hospital of Wales, Cardiff and Vale University Health Board, Heath Park Way, Cardiff CF14 4XW, UK; (O.U.)
| | - Jackie Bethel
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK; (J.B.); (R.D.)
| | - Annette Evans
- Research and Evaluation Division, Public Health Wales, Cardiff CF10 4BZ, UK
| | - Michael Seaborne
- Swansea University Medical School, Data Science Building, Singleton Park, Swansea SA2 8PP, UK; (M.S.); (S.B.)
| | - Rhian Daniel
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK; (J.B.); (R.D.)
| | - Sinead Brophy
- Swansea University Medical School, Data Science Building, Singleton Park, Swansea SA2 8PP, UK; (M.S.); (S.B.)
| | - Shantini Paranjothy
- Aberdeen Centre for Health Data Science, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK;
- Public Health Directorate, NHS Grampian, Summerfield House, 2 Eday Road, Aberdeen AB15 6RE, UK
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Ece B, Aydın S, Kantarci M. Antenatal imaging: A pictorial review. World J Clin Cases 2022; 10:12854-12874. [PMID: 36569012 PMCID: PMC9782949 DOI: 10.12998/wjcc.v10.i35.12854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/17/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Today, in parallel with the use of imaging modalities increases in all fields, the use of imaging methods in pregnant women is increasing. Imaging has become an integral component of routine pregnancy follow-up. Imaging provides parents with an early opportunity to learn about the current situation, including prenatal detection of anomalies or diseases, etiology, prognosis, and the availability of prenatal or postnatal treatments. Various imaging modalities, especially ultrasonography, are frequently used for imaging both maternal and fetal imaging. The goal of this review was to address imaging modalities in terms of usefulness and safety, as well as to provide demonstrative examples for disorders. And this review provides current information on selecting a safe imaging modality to evaluate the pregnant and the fetus, the safety of contrast medium use, and summarizes major pathological situations with demonstrative sonographic images to assist radiologists and obstetricians in everyday practice.
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Affiliation(s)
- Bunyamin Ece
- Department of Radiology, Kastamonu University, Kastamonu 37150, Turkey
| | - Sonay Aydın
- Department of Radiology, Erzincan University, Erzincan 24142, Turkey
| | - Mecit Kantarci
- Department of Radiology, Erzincan University, Erzincan 24142, Turkey
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Prabhu M, Kuller JA, Biggio JR, Biggio JR. Society for Maternal-Fetal Medicine Consult Series #57: Evaluation and management of isolated soft ultrasound markers for aneuploidy in the second trimester: (Replaces Consults #10, Single umbilical artery, October 2010; #16, Isolated echogenic bowel diagnosed on second-trimester ultrasound, August 2011; #17, Evaluation and management of isolated renal pelviectasis on second-trimester ultrasound, December 2011; #25, Isolated fetal choroid plexus cysts, April 2013; #27, Isolated echogenic intracardiac focus, August 2013). Am J Obstet Gynecol 2021; 225:B2-B15. [PMID: 34171388 DOI: 10.1016/j.ajog.2021.06.079] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Soft markers were originally introduced to prenatal ultrasonography to improve the detection of trisomy 21 over that achievable with age-based and serum screening strategies. As prenatal genetic screening strategies have greatly evolved in the last 2 decades, the relative importance of soft markers has shifted. The purpose of this document is to discuss the recommended evaluation and management of isolated soft markers in the context of current maternal serum screening and cell-free DNA screening options. In this document, "isolated" is used to describe a soft marker that has been identified in the absence of any fetal structural anomaly, growth restriction, or additional soft marker following a detailed obstetrical ultrasound examination. In this document, "serum screening methods" refers to all maternal screening strategies, including first-trimester screen, integrated screen, sequential screen, contingent screen, or quad screen. The Society for Maternal-Fetal Medicine recommends the following approach to the evaluation and management of isolated soft markers: (1) we do not recommend diagnostic testing for aneuploidy solely for the evaluation of an isolated soft marker following a negative serum or cell-free DNA screening result (GRADE 1B); (2) for pregnant people with no previous aneuploidy screening and isolated echogenic intracardiac focus, echogenic bowel, urinary tract dilation, or shortened humerus, femur, or both, we recommend counseling to estimate the probability of trisomy 21 and a discussion of options for noninvasive aneuploidy screening with cell-free DNA or quad screen if cell-free DNA is unavailable or cost-prohibitive (GRADE 1B); (3) for pregnant people with no previous aneuploidy screening and isolated thickened nuchal fold or isolated absent or hypoplastic nasal bone, we recommend counseling to estimate the probability of trisomy 21 and a discussion of options for noninvasive aneuploidy screening through cell-free DNA or quad screen if cell-free DNA is unavailable or cost-prohibitive or diagnostic testing via amniocentesis, depending on clinical circumstances and patient preference (GRADE 1B); (4) for pregnant people with no previous aneuploidy screening and isolated choroid plexus cysts, we recommend counseling to estimate the probability of trisomy 18 and a discussion of options for noninvasive aneuploidy screening with cell-free DNA or quad screen if cell-free DNA is unavailable or cost-prohibitive (GRADE 1C); (5) for pregnant people with negative serum or cell-free DNA screening results and an isolated echogenic intracardiac focus, we recommend no further evaluation as this finding is a normal variant of no clinical importance with no indication for fetal echocardiography, follow-up ultrasound imaging, or postnatal evaluation (GRADE 1B); (6) for pregnant people with negative serum or cell-free DNA screening results and isolated fetal echogenic bowel, urinary tract dilation, or shortened humerus, femur, or both, we recommend no further aneuploidy evaluation (GRADE 1B); (7) for pregnant people with negative serum screening results and isolated thickened nuchal fold or absent or hypoplastic nasal bone, we recommend counseling to estimate the probability of trisomy 21 and discussion of options for no further aneuploidy evaluation, noninvasive aneuploidy screening through cell-free DNA, or diagnostic testing via amniocentesis, depending on clinical circumstances and patient preference (GRADE 1B); (8) for pregnant people with negative cell-free DNA screening results and isolated thickened nuchal fold or absent or hypoplastic nasal bone, we recommend no further aneuploidy evaluation (GRADE 1B); (9) for pregnant people with negative serum or cell-free DNA screening results and isolated choroid plexus cysts, we recommend no further aneuploidy evaluation, as this finding is a normal variant of no clinical importance with no indication for follow-up ultrasound imaging or postnatal evaluation (GRADE 1C); (10) for fetuses with isolated echogenic bowel, we recommend an evaluation for cystic fibrosis and fetal cytomegalovirus infection and a third-trimester ultrasound examination for reassessment and evaluation of growth (GRADE 1C); (11) for fetuses with an isolated single umbilical artery, we recommend no additional evaluation for aneuploidy, regardless of whether results of previous aneuploidy screening were low risk or testing was declined. We recommend a third-trimester ultrasound examination to evaluate growth and consideration of weekly antenatal fetal surveillance beginning at 36 0/7 weeks of gestation (GRADE 1C); (12) for fetuses with isolated urinary tract dilation A1, we recommend an ultrasound examination at ≥32 weeks of gestation to determine if postnatal pediatric urology or nephrology follow-up is needed. For fetuses with urinary tract dilation A2-3, we recommend an individualized follow-up ultrasound assessment with planned postnatal follow-up (GRADE 1C); (13) for fetuses with isolated shortened humerus, femur, or both, we recommend a third-trimester ultrasound examination for reassessment and evaluation of growth (GRADE 1C).
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Huang H, Cai M, Liu L, Xu L, Lin N. Effectiveness of Chromosomal Microarray Analysis for Prenatal Diagnosis of Fetal Echogenic Intracardiac Focus: A Single-Center Experience. Int J Gen Med 2021; 14:1991-1997. [PMID: 34045891 PMCID: PMC8149271 DOI: 10.2147/ijgm.s311800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Echogenic intracardiac focus (EIF) is a common ultrasound finding during pregnancy. However, the correlation between fetal EIF and cardiac abnormality remains in dispute until now. The study aimed to examine the association of fetal EIF with chromosomal abnormality by means of chromosomal microarray analysis (CMA). MATERIALS AND METHODS A total of 192 pregnant women with fetal EIF undergoing amniocentesis or umbilical cord blood puncture were recruited and assigned into groups A (8 cases with isolated EIF alone), B (75 cases with EIF and other cardiac malformations) and C (109 cases with EIF and extracardiac malformations). All fetuses underwent karyotyping analysis and CMA simultaneously. The detection of chromosomal abnormality and copy number variations (CNVs) were compared. RESULTS Chromosomal karyotyping identified 5 fetuses with chromosomal abnormality, including 3 cases with trisomy 21, one fetus with Turner's syndrome, and one fetus with chromosome 8 mosaicism, while CMA detected 6 additional fetuses with CNVs, including 2 fetuses with pathogenic CNVs and 4 fetuses with variants of uncertain significance (VOUS). There was no significant difference among groups A (0), B (5.33%) and C (6.42%) in terms of the prevalence of chromosomal abnormality (P> 0.05). Among the 4 fetuses with VOUS, pregnancy continued in 2 fetuses, and pregnancy was terminated in other 2 fetuses. CONCLUSION An isolated EIF may not correlate with chromosomal abnormality. However, CMA is recommended in fetuses with CMA complicated by other abnormal cardiac ultrasound findings, which facilitates the prediction of fetal outcomes during the genetic counseling and precision assessment of prognosis.
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Affiliation(s)
- Hailong Huang
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
| | - Meiying Cai
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
| | - Linyu Liu
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
- School of Clinical Medicine, Fujian Medical University, Fuzhou City, Fujian Province, 350122, People’s Republic of China
| | - Liangpu Xu
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
| | - Na Lin
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
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Wrede E, Knippel AJ, Verde PE, Hammer R, Kozlowski P. Isolated Echogenic Cardiac Focus: Assessing Association with Trisomy 21 by Combining Results from a Prenatal Center with a Bayesian Meta-Analysis. Ultrasound Int Open 2020; 5:E98-E106. [PMID: 32159071 PMCID: PMC7062549 DOI: 10.1055/a-1118-3974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/05/2020] [Accepted: 02/06/2020] [Indexed: 12/13/2022] Open
Abstract
Objective
To investigate the clinical relevance of an isolated echogenic cardiac focus (iECF) as a marker for trisomy 21 using a large second-trimester collective including a low-risk subgroup.
Materials and Methods
We retrospectively evaluated 1 25 211 pregnancies from 2000–2016 and analyzed all iECF cases with regard to chromosomal anomalies. It consisted of an early second-trimester collective from 14+0−17+6 weeks (n=34 791) and a second-trimester anomaly scan collective from 18+0–21+6 weeks. Two a priori risk subgroups (high and low risk) of the latter were built based on maternal age and previous screening test results using a cut-off of 1:300. Likelihood ratios (LR) of iECF for the detection of trisomy 21, trisomy 13, trisomy 18 and structural chromosomal anomalies were estimated.
Results
In total, 1 04 001 patients were included. An iECF was found in 4416 of 1 02 847 euploid fetuses (4.29%) and in 64 of 557 cases with trisomy 21 (11.49%) giving a positive LR of 2.68 (CI: 2.12–3.2). The sensitivity was 11.5% at a false-positive rate of 4.29% (CI:4.17–4.42) with p≤0.01%. In the high-and low-risk subgroups, the prevalence of iECF was comparable: 5.08% vs. 5.05%. The frequency of trisomy 21 was 0.39%, 98/24 979 vs 0.16%, 69/44 103. LR+was 3.86 (2.43–5.14) and 2.59 (1.05–4). For both subgroups the association of iECF with trisomy 21 was statistically significant. The prevalence of structural chromosomal anomalies in the second-trimester anomaly scan collective was 0.08% (52/68 967), of which 2 showed an iECF.
Conclusion
The detection of an iECF at the time of 14+0–21+6 weeks significantly increases the risk for trisomy 21 in the high-risk and in the low-risk subgroups and does not statistically change the risks for trisomy 13/18 or structural abnormalitie.
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Affiliation(s)
- Elisabeth Wrede
- Praenatal-Medizin und Genetik, Düsseldorf, Kozlowski und Partner- Fachärzte für Gynäkologie und Humangenetik, Düsseldorf, Germany
| | - Alexander Johannes Knippel
- Praenatal-Medizin und Genetik, Düsseldorf, Kozlowski und Partner- Fachärzte für Gynäkologie und Humangenetik, Düsseldorf, Germany
| | - Pablo Emilio Verde
- Koordinierungszentrum für klinische Studien, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Ruediger Hammer
- Praenatal-Medizin und Genetik, Düsseldorf, Kozlowski und Partner- Fachärzte für Gynäkologie und Humangenetik, Düsseldorf, Germany
| | - Peter Kozlowski
- Praenatal-Medizin und Genetik, Düsseldorf, Kozlowski und Partner- Fachärzte für Gynäkologie und Humangenetik, Düsseldorf, Germany
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He M, Zhang Z, Hu T, Liu S. Chromosomal microarray analysis for the detection of chromosome abnormalities in fetuses with echogenic intracardiac focus in women without high-risk factors. Medicine (Baltimore) 2020; 99:e19014. [PMID: 32000445 PMCID: PMC7004657 DOI: 10.1097/md.0000000000019014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/18/2019] [Accepted: 01/03/2020] [Indexed: 01/01/2023] Open
Abstract
To investigate the association between pathogenic copy number variants (p-CNVs) and abnormal karyotypes detected by chromosomal microarray analysis (CMA) and echogenic intracardiac focus (EIF).This was a retrospective study of fetuses with EIF with CMA data at the Prenatal Diagnosis Center of the West China Second University Hospital of Sichuan University between September 2014 and May 2017. Fetuses were assigned to the isolated EIF and non-isolated EIF groups according to the presence of other ultrasound abnormalities.Among 244 pregnant women, there were 143 cases of isolated EIF and 101 of non-isolated EIF. CMA revealed chromosome abnormality (n = 9 (3.7%): trisomy 21, n = 4; sexual trisomy, n = 2; and p-CNV, n = 3), variants of unknown significance (VOUS, n = 19), and benign CNV (b-CNV, n = 216). Among the fetuses with isolated EIF, 5 had chromosomal abnormalities (3.5%). Among the fetuses with non-isolated EIF, four had chromosomal abnormalities (4.0%). All fetuses with trisomy 21 were in the non-isolated group. The frequency of labor induction was 66.7% (6/9) among the fetuses with chromosome abnormality and 21.1% (4/19) among those with VOUS. Among those with chromosomal abnormalities, one (11.1%) had congenital heart disease.In pregnant women without high-risk factors for chromosomal abnormalities, ultrasound abnormalities, including EIF, could be an indication for CMA. Ultrasound abnormalities (including EIF) and chromosome abnormality could indicate a high risk of CHD. The presence of EIF and at least another ultrasound abnormality could indicate a high risk of trisomy 21.
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Affiliation(s)
- Min He
- Departments of Ultrasound
| | - Zhu Zhang
- Departments of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University/Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu, China
| | - Ting Hu
- Departments of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University/Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu, China
| | - Shanling Liu
- Departments of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University/Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu, China
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Guo Y, He Y, Gu X, Zhang Y, Sun L, Liu X, Zhao Y, Han J. Echogenic intracardiac foci and fetal cardiac anomalies: A review of cases from a tertiary care center in China. JOURNAL OF CLINICAL ULTRASOUND : JCU 2018; 46:103-107. [PMID: 28961313 DOI: 10.1002/jcu.22533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/20/2017] [Accepted: 08/06/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE To investigate the relationship between the location of echogenic intracardiac foci (EIFs) and fetal cardiac anomalies in our patient population. METHODS We performed a retrospective study of the clinical files of fetuses who underwent an echocardiographic examination at our fetal cardiac medical center from August 2010 to August 2016. Fetuses were grouped by EIF location (left ventricle [LV], right ventricle [RV], or bilateral ventricles [BVs]). The maternal age, reason for referral, and cardiac anomalies in the three groups were analyzed. RESULTS We enrolled 2647 fetuses with an EIF. Of these, 2498 (94.4%) were in the LV group, while 45 (1.7%) and 104 (3.9%) were in the RV and BV groups, respectively. Aneuploidy was found in 3 fetuses, and all of these had a left-sided EIF. Cardiac anomalies were found in 93/2498 (3.7%) fetuses with a left-sided EIF, 5/45 (11.1%) of those with a right-sided EIF, and 3/104 (2.9%) of those with bilateral EIFs. The prevalence of congenital heart disease was significantly higher in fetuses with a right-sided EIF than in those with left-sided or bilateral EIFs (P < .05). CONCLUSIONS Right-sided EIFs were more frequently associated with fetal cardiac anomalies than were left-sided or bilateral EIFs.
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Affiliation(s)
- Yong Guo
- Department of Ultrasound, Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Yihua He
- Department of Ultrasound, Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Xiaoyan Gu
- Department of Ultrasound, Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Ye Zhang
- Department of Ultrasound, Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Lin Sun
- Department of Ultrasound, Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Xiaowei Liu
- Department of Ultrasound, Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Ying Zhao
- Department of Ultrasound, Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Jiancheng Han
- Department of Ultrasound, Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
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Murphy H, Phillippi JC. Isolated intracardiac echogenic focus on routine ultrasound: implications for practice. J Midwifery Womens Health 2016; 60:83-8. [PMID: 25712280 DOI: 10.1111/jmwh.12282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ultrasound is widely used as a screening tool for fetal anomalies. An intracardiac echogenic focus (ICEF) is associated with fetal aneuploidy, particularly trisomy 21, when found with other minor abnormalities known as soft markers. However, when found in isolation, intracardiac echogenic foci are morphologic variations with little or no pathologic significance for the fetus. Ambiguity about the significance of ICEF and other soft markers and the lack of preparation prior to ultrasound can result in unnecessary worry for women and their partners. A variety of tools exist that providers can use to help pregnant women and their partners make informed decisions about ultrasound and fetal screening.
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Soft markers for aneuploidy following reassuring first trimester screening: what should be done? Curr Opin Obstet Gynecol 2015; 27:151-8. [PMID: 25689239 DOI: 10.1097/gco.0000000000000157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW The present article aims to review the current role of the soft markers on the second trimester ultrasound (STUS) in women after reassuring first trimester screening (FTS) in singleton pregnancies. RECENT FINDINGS Improvements in the FTS and the recent implementation of noninvasive prenatal testing (NIPT) for common aneuploidies have important impact on the prevalence of these conditions in the STUS. Some studies suggest that soft markers in the second trimester of the fetus without structural anomalies have a minor or no role in Down syndrome detection in a prescreened population with reassuring results. However, NIPT could be offered as a next step in the management of such pregnancies if the calculated new composite risk (NCR) for aneuploidy is increased. In the case of reassuring results, pregnancy follow-up for certain markers is advised. SUMMARY NIPT has emerged as a new method of prenatal testing and is feasible in the second trimester in women with increased NCR. However, apart from the Down syndrome screening, STUS screening remains a powerful tool in screening for other fetal aneuploidies, structural anomalies and pathological placental conditions and detection of specific soft markers that require pregnancy follow-up.
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Martínez-Sánchez N, Robles-Marhuenda Á, Álvarez-Doforno R, Viejo A, Antolín-Alvarado E, Deirós-Bronte L, Bartha JL. The effect of a triple therapy on maternal anti-Ro/SS-A levels associated to fetal cardiac manifestations. Autoimmun Rev 2015; 14:423-8. [DOI: 10.1016/j.autrev.2015.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 01/12/2015] [Indexed: 10/24/2022]
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