Fetal hepatic calcifications: prenatal diagnosis and outcome.
OBJECTIVE
The purpose of this study was to provide information on the causes and postnatal outcomes of fetal liver calcifications that were detected by ultrasound imaging.


METHODS
Cases with fetal liver calcifications that were encountered between 1992 and 2001 were evaluated. A detailed fetal ultrasound imaging for associated abnormalities, maternal STORCH (syphilis, cytomegalovirus, herpesvirus 1 and 2, rubella, and Toxoplasma ) analysis, parvovirus serologic condition, and parental cystic fibrosis mutations analysis were performed; amniocentesis was offered in all cases. All infants who were born alive were examined and followed up.


RESULTS
Sixty-one pregnant women with fetal liver calcifications were identified. Forty of 61 patients had additional fetal abnormalities; 21 of 61 cases of fetal liver calcifications were isolated; 11/61 patients (18%) had abnormal karyotypes (trisomy 13, 4 patients; trisomy 21, 2 patients; trisomy 18, 1 patient; monosomy X (45,X), 1 patient; 4p-, 22q+, and 8p+, 1 patient). Ten of 11 patients with abnormal karyotypes had other abnormalities that were found on ultrasound imaging. Two patients had intrauterine infection, one patient had cytomegalovirus, and one patient had parvovirus B19 infection. Eighteen of 40 patients underwent pregnancy termination, one fetus died in utero, one newborn infant died, and two infants had neurologic sequelae. Of 21 patients with isolated liver calcifications, one fetus had parvovirus B19 infection and one infant had trisomy 21. The remainder of the infants each had a good outcome.


CONCLUSIONS
Fetal liver calcifications are relatively common. Isolated cases have a good prognosis after aneuploidy and infection have been ruled out. However, additional major abnormalities present a risk for chromosomal abnormalities, mainly trisomy 13.
Simchen
Michal J
MJ
Prenatal Diagnosis and Medical Genetics Program, Mt Sinai Hospital, Toronto, Ontario, Canada.
Toi
Ants
A
Bona
Mark
M
Alkazaleh
Fawaz
F
Ryan
Greg
G
Chitayat
David
D
D000028:Abortion, Induced; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000235:genetics; D002869:Chromosome Aberrations; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging; D003586:Cytomegalovirus Infections / Q000150:complications; D004314:Down Syndrome / Q000150:complications; D005260:Female; D005313:Fetal Death; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D007239:Infections / Q000150:complications; D007621:Karyotyping; D008107:Liver Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000235:genetics; D009422:Nervous System Diseases / Q000150:complications; D010322:Parvoviridae Infections / Q000150:complications; D016732:Parvovirus B19, Human; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D016216:Ultrasonography, Prenatal