Asymptomatic hyperechoic foci were noted within the left cardiac ventricular chamber on the prenatal sonograms of 26 patients between 16 and 20 weeks of gestation. Their range of occurrence, the prenatal follow-up in 12 patients and postnatal echocardiograms in six patients, indicate a clinically insignificant congenital anomaly associated with the chordae tendinae.
Ten cases displaying a focal area of increased echogenicity in the lower fetal abdomen on prenatal sonography are reported. This was an isolated finding in each case. Nine cases were noted early in the second trimester. The last case corresponded to a postmature gestation. In all cases, a normal lower abdomen was documented on follow-up prenatal sonography, at birth, or at autopsy. The authors believe that increased echogenicity in the lower fetal abdomen represents a normal variant that is more common than suggested by the literature. A possible explanation of this pattern is offered.
Discrete echogenic areas of 4 -12 mm were observed in the fetal stomach on seven prenatal sonograms. The finding was incidental and solitary during the second trimester in six normal pregnancies. It was noted during the third trimester in a case of meconium peritonitis. These echogenic areas displayed a homogeneous texture. They disappeared on repeat prenatal examination D etailed examination of the fetal abdomen on routine obstetrical examinations has yielded significant information on the normal appear· ance of several organs and has helped in the detection of various fetal abdominal anomalies. sing high-resolu. tion equipment, normal variants which can mimic path~ ologic conditions have been described. I -J We report seven cases of fetal gastric pseudomasses. Six of these were transient. We feel that awareness of this pattern should help avoid misinterpretation. MATERIALS AND METHODSThe prenatal sonograms of seven patients displaying an echogenic area within the fetal stomach were reviewed. Two patients were examined routinely between 17 and 20 weeks' gestational age prior to amniocentesis for advanced maternal age. Two patients were referred for high-resolution ultrasonography at 20 and 21 weeks because of a previous child with hydrocephaly. One patient was referred at 21 weeks because of elevated serum a· fetoprotein . One patient was referred at 23 weeks' gestation because of a previous child with an autosomal recessive genetic abnormality. The last case was seen at 32 weeks' gestation on follow-up examination of presumed meconium peritonitis.Five of the patients who were first seen with an echogenic area during the second trimester had a repeat pre~ natal examination after a time interval of 3-5 weeks.Immediate postnatal follow-up was available in all these cases and up to 12 weeks of age in two cases. The patient with a history of an autosomal recessive disorder suf+ fered a miscarriage 1 week after the ultrasound examination. An autopsy report was not available. The patient with the diagnosis of meconium peritonitis was reevaluated with several ultrasound examinations up to term. Correlative x-ray at birth and clinical follow-up up to 12 weeks were available.In each case, the finding in the stomach persisted throughout the ultrasound examination. Although we did not turn the patients from side to side during the examination, we could reproduce the same echogenic area when the fetus changed position in the amniotic fluid. Careful examination of the abdomen in search of
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