What is hyperechogenicity in the fetal heart
A hyperechoic focus of the fetal heart implies the presence of a seal in the structure of the heart muscle. As a result, ultrasound waves are reflected to a greater extent from a portion of the myocardium and give a bright spot on the screen. The inclusion, as a rule, has a diameter of 2-3 millimeters.
Most often it is found in women over 35 years old at 18-22 weeks of pregnancy. The phenomenon is most typical for representatives of Asian countries. On the European continent, this phenomenon is much less common (in 7-10% of cases). The lump usually disappears by the end of the third trimester, but often remains until delivery.
Most often, a hyperechoic inclusion is found in the left ventricle of the fetal heart; nevertheless, it can be visualized in other parts of the organ. The presence of increased echogenicity in the right sections is considered more dangerous.
This phenomenon can be considered pathological only in cases when it is accompanied by other signs of congenital diseases. It is also important to remember that this is just a diagnostic sign, which is not an independent pathology and does not bear any negative consequences in the future.
Causes
In some cases, a similar symptom is given by the presence of an additional chord. It is a connective tissue thread that runs from the heart valves to the papillary (papillary) muscles. Most often, one thread corresponds to each muscle, but in this case several of them are formed.
When blood passes through the chords, turbulence will occur, which can form heart murmurs heard on auscultation. This should be remembered, because in the future, due to the presence of this phenomenon, the pediatrician may make an incorrect diagnosis. Despite the fact that this phenomenon is considered as a heart anomaly, this type of development is accepted as normal.
The discovery of an additional chord does not require further investigation and treatment. As a rule, they grow together even before birth or in the first years of life.
It used to be thought that LV GEF was a clear sign of Down syndrome or other chromosomal disorders. But in recent years, many scientific works have appeared, thanks to which it is now known that this is true only in the presence of additional symptoms. Detection of this symptom alone should not be a cause for concern; further examinations are not required.
Action tactics
In most cases, if a hyperechoic inclusion is detected, an additional study is indicated. In this case, they can appoint:
- repeated ultrasound to clarify the diagnosis;
- echocardioscopy (performed only up to the 25th week);
- blood chemistry;
- karyotyping.
Invasive diagnostic procedures are rarely used:
- amniocentesis (taking a sample of amniotic fluid through the abdominal wall);
- Placentocentesis (biopsy of placental cells);
- fetoscopy (examination of the fetus using a video probe).
First of all, of course, genetic causes of hyperechoic inclusion should be excluded. For this, the diagnostician searches for other small markers of chromosomal pathologies. These include congenital heart defects, thickening of the cervical fold, disorders of the development of the gastrointestinal tract, skeletal system. They are usually detected during ultrasound examination. If they are found, it is necessary to consult a geneticist.
If no additional signs are found, the fetus can be considered completely healthy. However, follow-up echocardiography is recommended in the first months after birth. This procedure will allow you to finally make sure that there are no pathological changes.
Conclusions
Thus, the hyperechoic inclusion detected by ultrasound is not an independent diagnosis. According to the system of assessing markers of chromosomal abnormalities, he is awarded only one point, which cannot be a cause for concern.
Most often, GEF occurs due to physiological processes or benign anomalies in the development of the heart (the appearance of a false chord). Moreover, if no other anatomical or functional abnormalities are found, no further examinations and treatment are required. There will be enough control during a planned ultrasound scan in the third trimester of pregnancy.
