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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Isolated echogenic intracardiac foci in patients with low-risk triple screen results: assessing the risk of Trisomy 21

Nikki Koklanaris1 / Ashley S. Roman2 / Mary Ann Perle3 / Ana Monteagudo4

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Corresponding author: Nikki Koklanaris, MD NYU School of Medicine 530 First Avenue Suite 9NB-26A New York, NY, 10016 Tel.: +1-212-263-8122 Fax: +1-212-263-7890

Citation Information: Journal of Perinatal Medicine. Volume 33, Issue 6, Pages 539–542, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/JPM.2005.096, December 2005

Publication History

Received:
July 15, 2005
Accepted:
August 9, 2005

Abstract

Objective: While an echogenic intracardiac focus (EIF) is associated with an increased risk of trisomy 21 (T21), the magnitude of that risk remains controversial, particularly in the setting of a low-risk triple screen (TS). The objective of this study is to define the risk of T21 in patients with a low-risk TS and an isolated EIF.

Study design: A retrospective analysis was performed on patients presenting prior to 22 6/7 weeks of gestation. Patients met criteria for inclusion if an EIF was noted, a TS had been drawn, the anatomic survey was complete and was determined to be normal, and karyotyping or delivery occurred at Bellevue Hospital. A high-risk TS was defined as a risk of <1:500, assuming a 2-fold increased risk in the setting of an isolated EIF. A low-risk TS was defined as a risk of >1:500. Statistical analysis was performed using chi-square, with p values of <0.05 considered significant.

Results: 7,318 anatomic surveys were performed. An EIF was identified in 584 patients (7.98%), of which 391 met the criteria for inclusion. Of the 391, 51% were Asian and 38% were Hispanic; 348 had a low-risk TS and 43 had a high-risk TS. Patients with an EIF and a low-risk TS had a significantly lower risk of having a T21 pregnancy compared to those with a high-risk TS and an EIF (0 vs. 2.3%; p=0.004).

Conclusion: An isolated EIF with a low risk TS is not associated with an increased risk of T21.

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[1]
Jaime L. Natoli, Deborah L. Ackerman, Suzanne McDermott, and Janice G. Edwards
Prenatal Diagnosis, 2012, Volume 32, Number 2, Page 142
[2]
Mary Carolan and Ellen Hodnett
Midwifery, 2009, Volume 25, Number 6, Page 654
[3]
Alexander M. Friedman, Colin K. L. Phoon, Shira Fishman, David E. Seubert, Ilan E. Timor-Tritsch, and Nadav Schwartz
Obstetrics & Gynecology, 2011, Volume 118, Number 4, Page 921
[4]
G. R. DeVore
Ultrasound in Obstetrics and Gynecology, 2010, Volume 35, Number 5, Page 509
[5]
Brooke T. Davey, David E. Seubert, and Colin K. L. Phoon
Obstetrical & Gynecological Survey, 2009, Volume 64, Number 6, Page 405

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