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Gynecology  (Expert Forum)
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Brigth spot on heart of my unborn baby
Answered by
Keith Downing, MD - Obstetrics, Gynecology
MA
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Brigth spot on heart of my unborn baby

by jazmari, May 13, 2008 03:49PM
Hi!  I am 29 yrs old and I'm pregnet wih my second baby.  I had an ultrasoun done yesterday and the dr told me that he had seen a brigth spot in my babies heart.  He said that this  brigth spot can cause down simdrom.  A month ago I had a blood test done to check if the baby was ok and that she(the baby) didn't have any anormality.  My dr said that the blood test came out ok that there was nothing wrong with my baby.  I am very worry about my baby having down sindrom.  The dr said that if I had the blood test and it came out ok that there was nothing to worry about.  That it was a 1% change that my baby has down simdrom.  But I mean if there is nothing to worry about why did he mantion it? And what does a brith spot on the heart have to do anything with donw simdrom?  What is a brith spot?  or did I do something wrong during my first moths of my pregnancy that caused the brigth spot in my babies heart?  The dr said if I want I can have a test done where they insert a niddle through my belly and get liquid from the plasenta to make sure that the baby is ok or not.  But there is a risk of me having a miscarriage.  My dr gave only until this friday the 16th to think about having this test done.  I really don't now what to do!!!!    One more question if I had unprotected sex in january 4th and I got pregnat, which I am, when is my due date.  I am not sure of my last period.  I now it was some time at the end of dec.  but I am not sure.  My dr. gave a date but I want a second opinion.   Thank you very much for your help.

by Keith Downing, MD, May 16, 2008 11:26AM
Hello,

If you have an uncertain LMP you would be most accurately dated by an early ultrasound.  Telling me the date you think you conceived is unfortunately not a reliable way to date a pregnancy.  Ask your doctor what your ultrasound dating is, that will be the most helpful.

It sounds like your doctor has counseled you well.  That bright spot on the baby's heart is called an echogenic intracardiac focus (a fancy term for a calcified area in the baby's heart muscle).  This doesn't cause Down Syndrome, and doesn't relate to poor heart function later in life; and is not related to anything you did or didn't do earlier in the pregnancy.  It is seen in many normal baby's, especially baby's that are ethnically Asian.  However, it is seen more commonly in baby's who do have Down syndrome.  For that reason it raises some concerns when seen; we call it a "soft" marker for Down syndrome.  If the rest of your testing has been normal that is reassuring, but not 100% reassuring.  To know more accurately an amniocentesis would have to be performed.  As you stated it involves placing a needle through your belly into the sac of the baby and removing some of the fluid (amniotic fluid) from around the baby and looking at its chromosomes.  This is very accurate in detecting chromosomal anomalies.  However, it does come with the possible risk of leading to membrane rupture and possibly pregnancy loss (the risk is generally quoted to be about 1/200, but it is probably less than that in experienced hands and using ultrasound guidance).

Talk with your doctor more about these issues.  Ask them if they can refer you to a genetics counselor; you may find they offer you more helpful information.

Best regards,

Dr. Downing  
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