Rastegar Mazyar, Rajaei Shahrokh, Yazdian Anari Negin, Hashemi Seyyed Mohammad, Entezar Baghiatallah Amir, Ghazalgoo Arezoo, Namazi Sholes, Soltani Moghadam Saman, Aleali Maryam Sadat, Keivanlou Mohammad-Hossein, Amini-Salehi Ehsan
Department of Pediatric Cardiology, Clinical Research Development Center of Children's Hospital.
Student Research Committee.
Ann Med Surg (Lond). 2024 Jun 13;86(8):4358-4363. doi: 10.1097/MS9.0000000000002260. eCollection 2024 Aug.
Ventricular echogenic foci are small structures within the hearts of some fetuses. These small areas result from increased echogenicity in the ventricles of fetuses located near the papillary muscles. An association between these foci and chromosomal abnormalities in fetuses has been reported. Considering that chromosomal abnormalities are a major cause of prenatal death, this study aimed to determine the value of fetal echogenic foci as markers for chromosomal abnormalities.
Fetal echocardiography was performed by an experienced cardiologist on 149 pregnant women in the second trimester. Of these, 75 were reported to have positive echogenic foci, and 74 were reported to have no echogenic foci. Subsequently, the three chromosomal anomalies including trisomies 21, 18, and 13 were examined. The information of the individuals, including gestational age and echogenic foci, was recorded.
Based on the findings of the present study, seven infants (4.7%) had trisomy 21, four infants (2.7%) had trisomy 13, and six infants (4.1%) had trisomy 18. The mean gestational age of pregnant women with positive and negative echogenic foci was 21.07±3.23 and 21.03±3.09, respectively. No significant relationship was found between ventricular echogenic foci and trisomy 21, 18, or 13.
The present study suggests no significant relation between the presence of echogenic foci and chromosomal trisomies. This finding indicates that additional tests are required to confirm chromosomal abnormalities when echogenic intracardiac foci are present, especially in high-risk fetuses. Moreover, the absence of echogenic focus does not rule out chromosomal disorders.
心室强回声灶是部分胎儿心脏内的小结构。这些小区域是由于位于乳头肌附近的胎儿心室回声增强所致。已有报道称这些病灶与胎儿染色体异常有关。鉴于染色体异常是产前死亡的主要原因,本研究旨在确定胎儿强回声灶作为染色体异常标志物的价值。
由一位经验丰富的心脏病专家对149名孕中期孕妇进行胎儿超声心动图检查。其中,75名被报告有阳性强回声灶,74名被报告无强回声灶。随后,对包括21三体、18三体和13三体在内的三种染色体异常进行了检查。记录了包括孕周和强回声灶在内的个体信息。
根据本研究结果,7名婴儿(4.7%)患有21三体,4名婴儿(2.7%)患有13三体,6名婴儿(4.1%)患有18三体。有阳性和阴性强回声灶的孕妇的平均孕周分别为21.07±3.23和21.03±3.09。未发现心室强回声灶与21三体、18三体或13三体之间存在显著关系。
本研究表明强回声灶的存在与染色体三体之间无显著关系。这一发现表明,当存在心内强回声灶时,尤其是高危胎儿,需要进行额外检查以确认染色体异常。此外,无强回声灶并不排除染色体疾病。