title: Echogenic intracardiac focus on second trimester ultrasound: prevalence and significance in a Middle Eastern population.
abstract: OBJECTIVE
  The association between echogenic intracardiac focus (EIF) and trisomy 21 is well established, with a recognized ethnic variation. Our study aimed to determine the prevalence of EIF in a Middle Eastern population and to examine its association with trisomy 21 and other adverse pregnancy outcomes.
  
  
  METHODS
  Retrospective case-control study of second-trimester obstetric sonograms (16-28 weeks) performed at a tertiary care center over a 5-year period. Cases with EIF were retrieved, and a matched control group with no EIF was identified. The incidence of trisomy 21 and other adverse pregnancy outcomes was compared.
  
  
  RESULTS
  A total of 9270 obstetric sonograms were examined, with an EIF prevalence of 2.5% (95% CI: 2.2-2.8%). Of patients with available outcome data, EIF was not associated with trisomy 21 (0/163 versus 1/163; p value = 1.00). Additionally, EIF was not associated with trisomy 18, trisomy 13, small for gestational age, preterm birth, fetal demise, cesarean delivery, operative vaginal delivery, or admission to the neonatal intensive care unit.
  
  
  CONCLUSIONS
  In a contemporary Middle Eastern population, EIF is a rare occurrence. As an isolated finding, it is not associated with aneuploidy or other adverse pregnancy outcomes. EIF appears to be incidental with no impact on clinical practice.
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon .|b Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , Columbia University Medical Center , New York , NY , USA .
authors.forename: Fadi G
authors.initials: FG
authors.lastname: Mirza
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon .
authors.forename: Labib
authors.initials: L
authors.lastname: Ghulmiyyah
authors.affiliation: c Department of Internal Medicine , American University of Beirut Medical Center , Beirut , Lebanon , and.|d Biostatistics Unit, Clinical Research Institute, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Hani
authors.initials: H
authors.lastname: Tamim
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon .
authors.forename: Farah
authors.initials: F
authors.lastname: Bou Hamdan
authors.affiliation: c Department of Internal Medicine , American University of Beirut Medical Center , Beirut , Lebanon , and.
authors.forename: Juliana
authors.initials: J
authors.lastname: Breidy
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon .
authors.forename: Sandra
authors.initials: S
authors.lastname: Geagea
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon .
authors.forename: Ihab
authors.initials: I
authors.lastname: Usta
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon .
authors.forename: Abdallah
authors.initials: A
authors.lastname: Adra
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon .
authors.forename: Anwar H
authors.initials: AH
authors.lastname: Nassar
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D004314:Down Syndrome / Q000175:diagnosis; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007861:Lebanon; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal
keywords: Aneuploidy; Down syndrome; ethnicity; fetal heart; trisomy 21