Echogenic intracardiac foci: disclosure and the rate of amniocentesis in low-risk patients

• Published in: American journal of obstetrics and gynecology Vol. 209; no. 4; pp. 377.e1 - 377.e3
• Main Authors: Chasen, Stephen T., MD, Razavi, Armin S., MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.10.2013
• Subjects: Adult; alpha-Fetoproteins - metabolism; amniocentesis; Amniocentesis - utilization; Chorionic Gonadotropin, beta Subunit, Human - blood; Disclosure; Down syndrome; Down Syndrome - blood; Down Syndrome - diagnosis; echogenic intracardiac focus; Estriol - blood; Female; Fetal Heart - diagnostic imaging; Humans; Inhibins - blood; Nuchal Translucency Measurement; Obstetrics and Gynecology; Patient Preference; Pregnancy; Pregnancy-Associated Plasma Protein-A - metabolism; Retrospective Studies; Risk Assessment - methods; Ultrasonography, Prenatal; echogenic intracardiac focus; amniocentesis; Down syndrome
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2013.05.046

Objective Our objective was to determine the impact of disclosure of echogenic intracardiac focus (EIF) on the rate of amniocentesis in women who have undergone sequential testing. Study Design This was a retrospective study of women who had sequential testing for Down syndrome from 2009 through 2011. The Down syndrome risk was doubled in pregnancies with EIF, consistent with counseling provided to patients. In the control group Down syndrome risk was based on sequential testing. Within risk categories (1 in <250, 251-1000, 1001-5000, >5000) rates of amniocentesis with and without documented EIF were compared using Fisher exact test. Results In all, 4429 women at a median maternal age were included, including 229 with EIF (5.2%). In those at highest Down syndrome risk (1 in <250), rates of amniocentesis were similar between the 2 groups. In those at lower levels of risk, the rate of amniocentesis was significantly higher following disclosure of EIF compared to pregnancies without EIF at similar levels of risk. Conclusion Except for those at highest risk, rates of invasive testing were significantly higher in pregnancies with isolated EIF vs those at comparable risk.