Fetal intracardiac echogenic foci: does it matter which ventricle?

We sought to determine whether an association exists between the location of intracardiac echogenic foci and fetal aneuploidy or structural cardiac lesions. A search of the English language literature since 1980 revealed nine studies reporting location of intracardiac echogenic foci, fetal chromosomal abnormalities, and cardiac anomalies. Aneuploidy was noted in 10 of 217 fetuses with left ventricular and in one of 18 with right ventricular intracardiac echogenic foci. Three of 11 fetuses with biventricular intracardiac echogenic foci were aneuploid, which is significantly more frequently than when intracardiac echogenic foci were present in either ventricle alone (P = 0.02). There were nine cases of trisomy 21, four of trisomy 13, and one of trisomy 18. Structural cardiac lesions were recognized in eight of 217 fetuses with left ventricular foci, two of 18 with right ventricular foci, and one of 11 with biventricular intracardiac echogenic foci (P = 0.16). Biventricular intracardiac echogenic foci are more frequently associated with fetal aneuploidy but not structural lesions, as compared to isolated left or right ventricular intracardiac echogenic foci.