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Isolated fetal echogenic intracardiac foci or golf balls: is karyotyping for Down's syndrome indicated?
Author(s) -
Thilaganathan Baskaran,
Olawaiye Alexander,
Sairam Shanthi,
Harrington Kevin
Publication year - 1999
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1999.tb08184.x
Subject(s) - intracardiac injection , medicine , echogenicity , down syndrome , population , obstetrics , gestation , pregnancy , prospective cohort study , gynecology , radiology , ultrasound , genetics , environmental health , psychiatry , biology
Objective To determine the prevalence of isolated echogenic intracardiac foci and the subsequent risk for Down's syndrome at 18–23 weeks in an unselected obstetric population. Design Prospective study. Setting A district general hospital serving a routine obstetric population. Participants 16,917 pregnant women who underwent a routine ultrasound screening at 18–23 weeks of gestation between November 1994 and August 1998. Methods All women were offered screening for Down's syndrome by nuchal translucency or maternal serum biochemistry. The prevalence of isolated echogenic intracardiac foci was determined and the relative risk for Down's syndrome was calculated for different ultrasound findings. Results The combined sensitivity of age, nuchal translucency and maternal serum biochemistry for Down's syndrome was 84% (27/32). The relative risk for Down's syndrome was 0.17 (95% CI 0.07–0.41) for the women with normal scan findings at 18–23 weeks. The prevalence of isolated echogenic intracardiac foci at 18–23 weeks was 0.9% (144/16,917). None of these pregnancies were affected by Down's syndrome. Conclusion The significance of the association between isolated echogenic intracardiac foci and Down's syndrome is a matter of ongoing debate. The data of this study suggest that in an unselected obstetric population with prior, effective, routine Down's syndrome screening, the association between isolated echogenic intracardiac foci and Down's syndrome is no longer significant.