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Postnatal outcome of fetal cardiac echogenic foci
Hong-Hsing Liu1, Ming-Tai Lin, Chien-Chih Chang
1Departments of Pediatrics and Obstetrics/Gynecology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan.
Insights
Fetal cardiac echogenic foci often disappear after birth, with most resolving by age four. Persistent foci in infants are typically not linked to significant heart abnormalities.
Area of Science:
- Cardiology
- Fetal Medicine
- Pediatric Echocardiography
Background:
- Cardiac echogenic foci are common prenatal findings.
- Limited data exist on postnatal outcomes.
- Potential association with papillary muscle mineralization.
Purpose of the Study:
- Investigate clinical characteristics of fetuses with cardiac echogenic foci.
- Determine postnatal echocardiographic findings in these infants.
Main Methods:
- Retrospective study of 43 fetuses with cardiac echogenic foci.
- Postnatal echocardiography performed on 20 infants (17 months to 4y 7m).
- Exclusion of fetuses/infants with other congenital malformations.
Main Results:
- 35% of infants had persistent cardiac echogenic foci.
- Only one infant showed mild mitral valve prolapse without regurgitation.
- Foci generally regressed with age; 11% persistence at last follow-up.
- No significant difference in persistence between univentricular and biventricular foci.
Conclusions:
- Fetal cardiac echogenic foci often resolve postnatally.
- Persistent foci are not associated with significant cardiac anomalies.
- Reassurance for parents regarding isolated findings.
Background And Purpose:
Cardiac echogenic foci are found frequently during fetal echocardiographic investigations and may be related to increased mineralization of the papillary muscles. However, data from postnatal follow-up are limited. This study investigated the clinical characteristics and postnatal echocardiographic findings in infants with cardiac echogenic foci identified prenatally.
Methods:
Between March 1995 and April 1998, 43 fetuses were noted to have cardiac echogenic foci during the second trimester. Postnatal evaluation was completed for 20 of these 43 fetuses. No other congenital malformations were noted during the fetal stage or after birth. Postnatal echocardiography was performed from 17 months to 4 years and 7 months after birth.
Results:
Seven (35%) infants had persistent cardiac echogenic foci. However, only one had mild mitral valve prolapse without mitral regurgitation. All fetuses had left ventricular (LV) foci and three also had right ventricular (RV) foci. One infant who had a LV focus prenatally was noted to have a RV focus on postnatal follow-up. Among the three infants with prenatal biventricular involvement, only one had biventricular involvement on postnatal follow-up. Other cardiac echogenic foci had disappeared in all infants. The probability of persistence of foci decreased with age and reached 50% at the age of 4 years and 4 months. Thereafter, cardiac echogenic foci tended to regress and only 11% of infants had persistence at the last follow-up. No significant difference was found in the rate of persistence between children with univentricular foci and those with biventricular foci.
Conclusions:
Although some fetal cardiac echogenic foci may persist after birth, fetal echogenic foci were not associated with significant intracardiac or extracardiac anomalies.