ultrasound diagnosis of fatal anomalies

WHITE SPOT
Fig. 10.15 White spot. There is an echogenic focus
in the left ventricle.
Fig. 10.16 White spot. An echogenic focus seen in
both ventricles at 12 +5 weeks.
echogenicity of a vertebral body is used as a reference
measurement. The findings are more
frequent before 20 weeks of gestation rather
than in late pregnancy.
Clinical management: Further ultrasound
screening, including fetal echocardiography;
possibly karyotyping.
Prognosis: Studies on this subject are controversial.
Some reports do not describe any increase in
the risk of chromosomal disorders; the majority,
however, postulate a twofold to fourfold increase
in the risk of Down syndrome. The risk is
especially high if a complex pattern of white
spots is present, or if the right ventricle is involved.
Benacerraf found that, in 14 fetuses with
Down syndrome, only one showed an isolated
white spot without evidence of other anomalies;
the maternal age in this case was 40 years.
References
Degani S, Leibovitz Z, Shapiro I, Gonen R, Ohel G. Cardiac
function in fetuses with intracardiac echogenic foci.
Ultrasound Obstet Gynecol 2001; 18: 131–4.
Petrikovsky B, Challenger M, Gross B. Unusual appearances
of echogenic foci within the fetal heart: are
they benign? Ultrasound Obstet Gynecol 1996; 8:
229–31.
Petrikovsky B, Klein V, Herrera M. Prenatal diagnosis of
intra-atrial cardiac echogenic foci. Prenat Diagn
1998; 18: 968–70.
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