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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Should A Heart Spot With Fluid Be Treated In A Pregnancy?

Hi! How are u.. I am 26 weeks and 5 days pregnant. On our 20 week ultrasound they found a small white spot on the heart. On the 26 week ultrasound they found that the spot was a little smaller however there was some fluid around the heart as well as a slight echogenic bowel. The quad screen and the fetal cell free DNA maternity21 test all were clear. What should we do and what are we likely facing?
Mon, 30 May 2016
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OBGYN 's  Response
Hello,
I have gone through your query and understood the concern. White spot on the heart in a fetal echo is observed as a normal feature in many cases and is due to calcification. It is also observed in Down's syndrome and other trisomies etc. Echogenic bowel is a common finding in 75 percent of cases. It can happen due to swallowing of intraamniotic hemorrhage by the fetus, genetic defects, infections IUGR, IUD etc. Since you have had the anomalies ruled out through tests, you can rest assured that these are normal findings. Just have regular follow up and stay calm. Wish you good health.
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OBGYN Dr. Zenab Tambawala's  Response
Hi there,
Welcome to HCM,

The cell free Fetal DNA being clear for Downs is a very good sign. it is almost certain that your baby does not have Downs syndrome which is one of the first things to rule when ultrasound shows the soft markers you have described.

White spot or echogenic focus in heart is not a very significant finding and not considered as a indication for further testing.

The echogenic bowel though could be an indication of various conditions, like cystic fibrosis, Intra uterine growth retardation, viral infection.

Do you or your husband have any family history of cystic fibrosis?

Regular growth scans to see the growth parameters of this baby will be required through the remainder of your pregnancy.

Maternal blood to rule out TORCH infections, and Parvo virus B 19 is also required.

For the fluid around fetal heart please get a fetal 2D echo done to rule out any significant heart abnormality.

Hope this helps.
Regards.
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How Should A Heart Spot With Fluid Be Treated In A Pregnancy?

Hello, I have gone through your query and understood the concern. White spot on the heart in a fetal echo is observed as a normal feature in many cases and is due to calcification. It is also observed in Down s syndrome and other trisomies etc. Echogenic bowel is a common finding in 75 percent of cases. It can happen due to swallowing of intraamniotic hemorrhage by the fetus, genetic defects, infections IUGR, IUD etc. Since you have had the anomalies ruled out through tests, you can rest assured that these are normal findings. Just have regular follow up and stay calm. Wish you good health.