Prevalence of Cardiac Anomalies in Fetuses Diagnosed With Intracardiac Echogenic Foci: A Systematic Review and Meta-analysis

Objectives: The exact prevalence of cardiac anomalies in diagnosed cases of echogenic foci is still unknown, as various studies have been carried out across multiple populations with different methodologies.  Objectives: The primary objective of this study was to determine the precise prevalence of cardiac anomalies found in cases with intracardiac echogenic foci.  Methods: The authors manually searched the electronic databases (Cochrane Library, PubMed, EMBASE, Scopus, Web of Science). Two reviewers independently did data extraction and quality control; a third reviewer resolved any raised conflicts. The data were analyzed by comprehensive meta-analysis software version ۲. Risk of bias assessment and strobe checklist were used for quality assessment.  Results: Out of ۵۳۱ articles identified, ۳۲ studies met the inclusion criteria and were included in the meta-analysis with a total sample size of ۷۵۶۸. The pooled prevalence of cardiac anomalies in the fetuses with intracardiac echogenic foci was ۴.۸% (۹۵% CI, ۳.۶%-۶.۴%). Subgroup analysis was done according to the geographical distribution of cases, maternal age, gestational age, year of publication, risk of bias, and ultrasonography operator.  Conclusions: The current study represents the first and only meta-analysis concerning the prevalence of cardiac anomaly in fetuses diagnosed with intracardiac echogenic focus (ICEF). This study supports a definitive relationship between ICEF and underlying congenital heart disease. We recommend increased training of individuals performing this ultrasonography to improve early detection, ultimately enhancing the care given to infants immediately post-birth.