An echogenic intracardiac focus (EIF) is a discrete area of echogenicity identified sonographically within the fetal heart. EIF's are found in 1.5–4% of pregnancies and their presence reflects a twofold association: 1. Calcium mineralization of the papillary musculature 2. An increased risk of Trisomy 21/cardiac anomalies. The primary purpose of our study was to analyze the prevalence and outcomes of pregnancies affected by EIF and secondarily to correlate maternal calcium levels with EIF.
A retrospective chart review of routine anatomical surveys with findings of EIF between January 2004 and December 2014. Demographic and descriptive data were collected. Descriptive statistics, T test and ANOVA were used to assess associations between variables and EIF.
A total of 834 patients were identified with EIF; 134/834 (16%) were women age 35 or older compared to 700/834 (84%) of women age 15–34. The average age was 27.9 years. The average gestational age at diagnosis was 20w 2d. Of the patients, 56.6% underwent genetic counseling; 10% of patients had invasive prenatal testing while 16% pursued NIPT. No karyotypic abnormalities were noted. The average calcium level was 9 mg/dL.
The clinical significance of EIF remains an area of interest in fetal medicine. Our findings are consistent with previous studies that confirm low risk for fetal aneuploidy with their identification. Maternal calcium levels did not correlate with findings of EIF. We conclude that invasive testing is not clinically necessary. Increased utilization of genetic counseling may reduce the need for increased perinatal procedures and provide patient reassurance.
Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
Financial Disclosure: The authors did not report any potential conflicts of interest.