“An echogenic intracardiac focus (EIF) is a relatively common finding, even in otherwise normal fetuses. It is not a structural abnormality and considered a normal variant representing calcified deposits in the muscle of the fetal heart that appear as bright spots on prenatal ultrasound. SMFM considers an EIF a “soft marker” which is a “minor ultrasound finding” associated with an increased risk of aneuploidy.

If EIFs Are Seen in Isolation 

• Aneuploidy screening has not been performed
  • Offer screening options
    • NIPS or quad screen (if NIPS not available or too expensive)
  • If aneuploidy screening is negative
    • No further aneuploidy evaluation, follow up ultrasound or postnatal evaluation is recommended
  • If aneuploidy screen result is positive
    • Refer for genetic counseling and consideration of diagnostic testing options

If Other Anomalies are Present 

• Genetic counseling and offering diagnostic amniocentesis with microarray is indicated

Note: SMFM guidance does not recommend diagnostic testing for isolated soft markers if aneuploidy screening is negative, but supports offering diagnostic testing as an option to all pregnant people regardless of aneuploidy risk.” [Source]

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