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Isolated echogenic intracardiac focus

This document has been withdrawn and replaced with SMFM Consult Series #57: Evaluation and management of isolated soft ultrasound markers for aneuploidy in the second trimester.

Overview: An EIF is a common finding, seen in 3-5% of normal fetuses. When an EIF is identified, an experienced provider should perform a detailed fetal anatomic survey and assess for aneuploidy risk factors.

Diagnosis/definition: An EIF is a small, echogenic area within the fetal cardiac ventricle that has a sonographic brightness equivalent to bone. An EIF is not a structural or functional cardiac abnormality.

Epidemiology/Incidence: EIFs are seen in 3-5% of normal fetus, with prevalence as high as 30% in fetuses of Asian mothers.

Management:  Screening/Work-up: 

  • Evaluation includes a detailed anatomic survey by an experienced provider and assessment of risk factors for aneuploidy, including maternal age, results of other screening or diagnostic tests, and family history. 
  • If an isolated EIF is identified, multiply the patient’s a priori risk by a published likelihood ratio such as 2.9 to generate a modified risk.
  • No specific follow-up of EIF is recommended.