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Massive myocardial calcification in second‐trimester fetuses: antenatal detection and causes
Author(s) -
Chan Y. F.,
Sampson A.
Publication year - 2005
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.1812
Subject(s) - medicine , fetus , rhabdomyoma , arthrogryposis , pregnancy , in utero , cardiology , obstetrics , pathology , anatomy , tuberous sclerosis , genetics , biology
Abstract Massive myocardial calcifications were detected by antenatal ultrasound examination in four second‐trimester fetuses. In one fetus, multiple cardiac rhabdomyomas were the initial diagnosis. One fetus presented with arthrogryposis and the brain and spinal cord showed severe hypoxic‐ischemic damage. One fetus was hydropic and had severe cardiac malformations. The fourth fetus had congenital heart block and maternal serum was positive for anti‐Ro and anti‐La antibodies. Myocardial calcifications in the first three fetuses were most likely to be caused by hypoxic‐ischemic damage to the heart, and immunological mechanisms were responsible in the other fetus. Antenatally detected myocardial echogenic foci in a fetus leading to a termination of pregnancy or associated with fetal death should be investigated with a full postmortem examination. It is important to confirm the presence of calcifications as distinct from a rhabdomyoma as genetic counseling is completely different. The demonstration of associated lesions in other organs also helps to explain the pathogenesis underlying this condition. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.