title: Are maternal and sonographic factors associated with the detection of a fetal echogenic cardiac focus?
abstract: OBJECTIVE
  To evaluate the influence of maternal weight and the orientation of the fetal 4-chamber heart view on the detection of a fetal echogenic cardiac focus.
  
  
  METHODS
  In this nested case-control study, 103 women undergoing anatomic surveys at 15 to 22 weeks between January 1, 1997, and June 15, 1999, were identified as having an echogenic cardiac focus via our computerized database. A control group was selected from among the same group of patients. Data were collected from the sonography reports, prenatal records, and sonographic images of 4-chamber heart views; maternal characteristics and sonographic details were recorded, including the orientation of the 4-chamber view (apical, basilar, and right and left lateral).
  
  
  RESULTS
  Gravidas in the echogenic cardiac focus group were more likely to be of lower weight (68.0 +/- 14.4 versus 72.9 +/- 18.3 kg; P = .04), of lower body mass index (25.5 +/- 5.3 versus 27.3 +/- 6.2 kg/m2; P = .03), of younger age (24.4 +/- 6.5 versus 26.9 +/- 6.9 years; P = .01), and African American or Asian (37.9% versus 27.2% and 9.7% versus 2%; P = .01). Cases were scanned at earlier gestational ages (18.9 +/- 1.6 versus 19.5 +/- 1.7 weeks; P = .01). The focus group was more likely to have had an apical view of the fetal heart taken (80.8% versus 51.4%; P = .0001). Controls were more likely to have had a right lateral view taken (44.6% versus 20.8%; P = .002). No significant difference was found between groups in terms of any other maternal or sonographic variable studied.
  
  
  CONCLUSIONS
  The echogenic cardiac focus group was more likely to have a lower body mass index and to be scanned with the apical fetal heart view. The orientation of the fetal 4-chamber heart view exerted the most statistically significant influence on detection rates for the echogenic cardiac focus, implying that the more technically facile the sonographic study, the more likely an echogenic cardiac focus will be found.
authors.affiliation: Department of Obstetrics and Gynecology, Cooper Hospital/University Medical Center-Robert Wood Johnson Medical School, Camden, New Jersey, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Ehrenberg
authors.forename: R L
authors.initials: RL
authors.lastname: Fischer
authors.forename: M L
authors.initials: ML
authors.lastname: Hediger
authors.forename: C
authors.initials: C
authors.lastname: Hansen
authors.forename: D
authors.initials: D
authors.lastname: Stine
mesh_terms: D000367:Age Factors; D044383:Black People; D001835:Body Weight / Q000502:physiology*; D016022:Case-Control Studies; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging* / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy / Q000502:physiology*; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000379:methods*; D001741:Black or African American