Clinical value of isolated intracardiac echogenic focus in the fetal heart: A retrospective study in Chinese women

Purpose: To assess the resolution of intracardiac echogenic focus in gestation and to evaluate its association with fetal cardiac structural defects. Materials and Methods: Retrospective data of fetal echocardiography from January 2014 to December 2016 in low-risk pregnancies were collected. The study variables included observation resolution data of fetuses with intracardiac echogenic foci detected in the second-trimester, and follow-up data in the third-trimester. The Chi-square test was used to determine the association between intracardiac echogenic foci and fetal cardiac defects. Additionally, several statistical measures of performance for the foci as predictive markers were calculated. Results: The authors examined 8,120 fetuses. Among 531 fetuses with intracardiac echogenic foci, the overall incidence rate was 6.5% on a sonogram at 22-28 gestational weeks. The left ventricle was the most common site. Significant differences were observed between the locations and features of changes in the foci (χ2 = 18.68, p = 0.0009). No significant associations were found between the foci locations and fetal cardiac structural defects (Pfisher=0.28), or between the foci and cardiac defects [χ2 = 0.91, p = 0.34, OR = 0.72 with 95% confidence interval (0.40, 1.30)]. Conclusions: In most cases, isolated intracardiac echogenic focus was a transient sonographic marker during the gestational period. However, foci in the right ventricle were more stable than in the other locations. Intracardiac echogenic foci were not associated with cardiac defects, despite persistence in the third trimester.