To study the relationship between the presence and location of intracardiac echogenic foci (ICEF) and their potential association with congenital heart defects (CHDs)
Abstract
Background: Intracardiac echogenic foci (IEF) are common findings during second-trimester fetal ultrasound examinations, yet their relationship with congenital heart defects (CHDs) remains incompletely understood. This study investigated the association between the anatomical location of IEF and the presence of CHDs to enhance current risk assessment strategies. Methods: In this prospective observational study, we examined 100 pregnant women between 18-24 weeks of gestation who presented with fetal IEF during routine anatomical scanning. Detailed fetal echocardiography was performed in all cases, documenting the precise location of echogenic foci within the cardiac chambers. All cases underwent postnatal cardiac evaluation to confirm prenatal findings. The relationship between IEF location and CHDs was analyzed using multivariate logistic regression. Results: Among the study population, IEF were predominantly located in the left ventricle (48%), followed by the right ventricle (28%), both ventricles (16%), and other cardiac chambers (8%). Congenital heart defects were identified in 15 cases (15%), with a significantly higher prevalence in fetuses with bilateral IEF (adjusted OR: 3.8; 95% CI: 1.6-9.2; p = 0.002) and right ventricular IEF (adjusted OR: 2.4; 95% CI: 1.1-5.3; p = 0.038). Ventricular septal defects were the most common anomaly (40% of CHD cases), followed by atrial septal defects (20%). Conclusion: The anatomical location of IEF demonstrates significant association with the risk of congenital heart defects, with bilateral and right ventricular IEF carrying higher risks compared to isolated left ventricular IEF. These findings suggest the need for location-specific risk stratification in prenatal counseling and follow-up protocols.
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References
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