What a Difference a Day Makes

It was all vaginas and cupcakes around here until my midwife informed me this morning that my ultrasound showed an Echogenic Cardio Foci.

You say, wtf is that? And I say, I have no clue. And neither did my midwife.

I love midwives, but let them not be the ones to give you news regarding an Echogenic Cardio Foci that happens to be a teeny tiny even controversial marker (on its own, that is) for Down Syndrome because they will liken it to a hand crease and give you some bogus ratio and make you cry that heavy blubbering cry where you can't talk and you just want to run away but you're stuck in a fucking midwife's office.

Once I calmed down, let them take my blood for a Quad Screen, and scheduled an appointment for the super duper ultrasound, I was able to call my husband, talk to a few friends, some of whom have been in this same exact spot, and search around the internet.

And I feel better.

Apparently she also has an ovarian cyst too, you know, just make me worry even more, but I'm not supposed to worry about that because those are nothing. They just make your hormones really wacky (sweet, more excuses for my madness).  All this after the midwife informed me that their ultrasound machine isn't the greatest so there could have been other markers or actually, the marker could have not been there at all. But it was good enough to see a FUCKING CYST on her ovary.

Now I'm wondering if I'm having a girl. Did you hear, it's a GIRL! Yippppppppeeeeeeeee!

Truth be told, I've been ambivalent about this pregnancy. It's taken me until now to get excited. Partially due to my own anxiety about anything being wrong, but also because I'm living in a general state of overwhelm and I haven't had time to stop and say "WHOO! More kids!"

But yesterday, I got excited. I bought a pink onesie. I told the Gap Kids checkout lady (from whom I bought, not STOLE the onesie) that I'm having a girl. I don't want this to take away from that feeling.

So, if this trip takes us to Holland, we'll enjoy the detour. But I'm not going to feel bad for hoping, wishing, and hell, praying that every thing about this little girl is okay.

Comments

[BethanyWD]

I know I am SUPER late to this post, but I thought I would also add my experience to it. My daughter had the same thing show up on her 20 week ultrasound. I also had the quad screen (and the nuclear ultrasound) before that, showing no issues. In fact, my OB just mentioned it sort of off-handedly and reiterated that just the foci alone with no other markers and great quad screen numbers, probably didn't indicate any real concern. I, like you, went and did my internet research and confirmed what she said (you probably found the same research!). In the end, my husband and I decided, having our baby have downs syndrome would not affect how we felt about the pregnancy and it would not cause us to terminate the pregancy, so we sort of decided to put it out of our minds. I can say, however, I was relieved when she was born without DS. I know that my child having DS would not change my love for her, but I was happy none-the less.

[jonashpdx]

I just wanted to thank you for including the link to the Holland piece and not freaking out (entirely at least) about the prospect of having a little girl with DS. My own trip to Holland was a complete surprise after my wife's healthy and normal pregnancy/ultrasound/everything, and it was definitely a shock to the system to get off that plane and find out you were somewhere you didn't expect, but now that my boy has been here with us for a while, there's no way we'd change our reservations.

[Fairly Odd Mother]

I love that Holland piece. Hugs to you and hope all is well. It does seem like that the more we know about pregnancy, the less we can really be sure about any of it.

[Binky]

Gotta love technology for things like the Internet and blogging, but when it comes to these ultrasounds, they can cause a lot of unnecessary worry. Take heart in all the wisdom the previous commenters have bestowed upon you!

[Jessica]

Sending prayers for a perfectly healthy baby girl. Isn't it amazing that they will just throw those words around when they really have no clue.

Hang in there.

[Carolyn]

Can you help but worry when you're pregnant? Isn't there some worry hormone that you produce in vast quantity while incubating?

We live on the verge of Holland. Hard to expalin. Of course it's wonderful and strange and fun and frustrating. But how boring would my life be without the windmills?

[Lindsay]

Whoa. I know that ultrasound interminable wait, and I'm so sorry you're going through it. Mine have all been in really clinical offices, and I could see how being in the warm fuzzy midwife's office could exacerbate the surreal suckiness of the shock. I've got my fingers crossed for you, and I really hope you get solid news to make the waiting to see your little girl's face easier.
xoxo

[jeanie]

My nephew gave my sister a few heart palpitations in the ultrasound by showing ticking 3 marker boxes. They did further testing and thought he might be okay.

He was fine.

Well, except for a heart defect (that they failed to see in the ultrasound because they were busy looking for something else) - but he got great care and he is now an unstoppable 6 year old!

You gotta love modern medicine - if almost gives you a crystal ball, it almost offers perfect miracles - but sometimes it doesn't. A bit like nature.

Good luck on wherever you travel with your little girl.

[Jenni]

They told me daugher had all the markers of Down's. ALL OF THEM! She's normal as can be. She actually puts the boys to shame with how smart she is! ; )

I'm praying for you. I actually had a baby born with Downs but he had severe complications from being a preemie. None of his tests showed Downs.

Sometimes life is a crap shoot but most of the time it pays off in the end!

[Jenni]

They told me daugher had all the markers of Down's. ALL OF THEM! She's normal as can be. She actually puts the boys to shame with how smart she is! ; )

I'm praying for you. I actually had a baby born with Downs but he had severe complications from being a preemie. None of his tests showed Downs.

Sometimes life is a crap shoot but most of the time it pays off in the end!

[Manic Mommy]

Had to go through the level 2 ultra sound at 10 weeks and did the whole genetic counseling thing. Very scary stuff.

It feels so much better when they tell you all is well. Mothering these children really starts well before birth.

[Chag]

I hope everything turns out ok. I'll be hoping, wishing, and praying along with you.

[J from Ireland]

Aw you poor thing, sorry that your sad. Wishing, hoping and praying things will be fine for you.

[ellen]

I just went through this & it was so stressful for me. My 20 wk u/s showed TWO soft markers, but my baby was born fine just 2 wks ago. Reading all the stories of people like me who worried for no reason was the only thing that kept me sane, relatively speaking. Trying to have the right outlook & keep some perspective was tough - you sound like you're way ahead of where I was - try not to worry!

[the farmers wife]

In our family, we've had so many health related issues both real, imagined and whipped up by ultrasounds that we adopted the following policy:

We won't worry about something until someone tells us we have something to worry about. And then we'll worry all we want."

Just trust your health care professionals, do everything they tell you and that's all you can do.

- Suzanne, the Farmer's Wife

[sryan]

The idea of midwives brings to mind a holistic, wellness approach to motherhood. It seems to be the theme these days. Three of my mom friends kept on talking about the novel, "The Book of Mom" by Taylor Wilshire, which I just finished and loved. Have you read it? The novel is about a stay-at home mom that crashes and burns out and then through the help of a best friend a therapist and her humor how she finds a more balanced life inwardly and outworldy. I first thought it would be too self-helpie but often find just like a mid-wife that we need help in the realm of motherhood.

[SciFi Dad]

Our first ultrasound for our daughter showed "an echogenic focus in the left ventricle" which I believe is similar to what you are experiencing.

In our case, it turned out to be nothing; just some calcification.

I hope things work out for you. I'm sure everything will be fine.

[Sara]

Congrats on the girl! We have some friends who through the quad screen and nuchal translucency test were put into a high-risk DS status, and their perfectly healthy daughter was born 5 months later with no sign of chromsomal abnormalities. From what I understand those tend to be stronger DS markers. Hang in there, and I imagine that chances are your daughter will be just fine!

[Velma]

I know so many women who've had markers like this resolve and turn out to be nothing. And for those of us who ended up somewhere else - Holland, Spain, Las Vegas - well, the weather is lovely here, too!

[Mom101]

Hoping for a quick return to the days of vaginas and cupcakes

[CarolinaMama]

Congratualtions on your girl! And thoughts and prayers are with you through this.

[canape]

I'll be hoping, wishing, and praying right along with you.

[Jozet at Halushki]

Oh gosh...yes...so many stories of moms freaked the hell out for no reason.

Breath deeply and have someone rub your feet.

All is good. All is well.

[Queenie]

So exciting to have a girl! Congrats on getting to buy the pink onesie!

[I'm Not Skippy]

My son had one of those. It shows in 8 of 10 babies (how is that a marker for Down's?). We found it after my wife's quad screen came back positive. . . BTW a Down's Syndrome positive quad screen is a false positive 99% of the time (what kind of suck-ass test is that?), so even if that comes back positive it's not really positive.

The only way we were able to rule it out was a amnio. . . good news there is the risk has recently been reevaluated and it's not as risky as it used to be. Only a 1 in 4800 chance of losing the baby vs 1 in 200.

Don't you love statistics when discussing you baby?

[tracey]

I have no other advice than to hang in there. You know that she will be fine, no matter how many chromosones she may or may not have. Sending you loads of hugs and support...

[the new girl]

Anything that makes my girl too sad to shop is FUCKED UP.

I'm sorry that you're having this experience on top of an already. FULL. PLATE.

You always and only want to hear that one thing, 'everything is FINE,' and when you don't hear that, it's all white noise and panic.

I wish I was there to give you a squeeze and go to the mall with you.

[Rachael]

Try not to worry, nothing means anything yet. I will be thinking about you and your baby!

[magpie]

I've heard of so many people with that soft marker...

Good luck.

[Adela]

My 5 month old also had the echogenic focus. I loved how the tech explained it was like a freckel on the heart, that it really had nothing to do with anything and that it would probably be gone by the end of the pregnancy. Then the perinatologist gave us the "soft marker" blow out of nowhere. I almost passed out. All my blood work was excellent but I chose (against my OBs recommendation) to have an amnio, because I needed to know with absolute certainty one way or the other. My daughter was fine. The focus showed up until the very last ultrasound the day of my c-section. Then when she was born, they did an ultrasound of her heart and there was nothing there. No explanation, no anything - just not there. From what I've researched and have been told by doctors, the majority don't even consider this a marker for DS anymore because it is so vague. Don't put to much weight on it and definitely don't let it ruin your excitement. Best wishes.

[Amy Jo]

Maybe you had the same u/s doc as me. The EXACT same thing happened to me when I was pregnant with Lucy. Are you in the Northside Hospital circle? Here's what happened with me:

http://cheeseparty.blogspot.com/2007/04/ill-scratch-your-back-if-you-scratch.html

http://cheeseparty.blogspot.com/2007/04/andexhale.html

I'm sure your little lady will be just fine, as mine was.

And? Yay for vaginas!

[motherbumper]

Thinking of you and wishing, hoping, praying that everything with your little girl (omg!) is okay.

[laura]

{{{{hugs}}}}}
we took that trip to holland when we adopted our beautiful boy (darling circus clown #5). it can be a rough trip at times but not a day goes by where i DON'T regret jumping on that plane.
Bon Voyage where ever it takes you. i look forward to hearing how your darling daughter looks in her gap onesie.
take care.

[Mrs. March]

Congratulations on the little girl. She is going to be beautiful! I had similar results with my third daughter. I remember the horrible fight I had with my 60 year old neighbor who recommended that I abort. It was a painful(uncontrolled crying) six weeks waiting to get more information. She is my most "gifted" child, truly brilliant. Then 18 months later I found out her older sister had autism. I don't think we ended up in Holland. It's more like Las Vegas, lights, sounds, never stops. Oh, but it has moments that are truly, truly, wonderful. If I was given the power to "fix" her I don't know that I could. She wouldn't be her! Best Wishes and Prayers during the horrible time of waiting. The waiting is almost worse then the knowing.

[Mothering Two]

I LOVE that Holland comparison. No matter what happens, you sound like such an amazing mama.

[Melissa P.]

PS-I do live in Holland.
It does not show up on an ultrasound, but autism is a permanent trip to Holland.
Especially with 2 sons.
I would not miss it for the world!

[Melissa P.]

Many good thoughts and prayers coming your way, Kristen.
A GIRL!
How fabulous!
I hope your next appt. is really soon so you can quit worrying and being scared.
Hang in there!
We are here for you.

[jennielynn]

I'm praying. (that you don't punch the midwife.) And that everything is fine with the baby girl! YAY, Vaginas!

[margalit]

When I saw the reference to OurKids.org, my heart jumped. My friend Ashley and I started ourkids 15 years ago as a private mailing list. Ashley's son Austin is about 4 months older then my twins and has an amazing story about how he was diagnosed... it isn't a good story, but it is amazing. I'm glad you found ourkids, but please don't panic. Foci are weak markers as other commenters have pointed out, and until you get a high res ultrasound and know if and what you're dealing with, be calm.

The trip to Holland is often strange, but it's my favorite place ever.

[Amy]

The same exact thing happened in my sono with my daughter. My OB said that alone, it means nothing. With other markers, it might mean something. I remember freaking out about it and her saying that she really didn't want to tell me but had to, and the reason she didn't want to tell me was because it truly means nothing. Keep buying those pink onesies :)

[Bitchy Mom]

((( HUGE HUGS )))

:-) Praying for you!

[momslifesavers]

Awww, Kristen - I'm holding you in my thoughts and know, from the posts preceeding mine, that I'm sure everything is JUST fine. I'll be thinking of you! :) Rest and Take it easy!!! :)

[Oh, The Joys]

I'm "holding you in the light" as the Quakers say.

xo,
OTJ

[Heather]

Any even remotely negative-sounding news is hard when you're pregnant and emotional anyway. Hang in there.

[dorothy]

The little angel had a weird triple-test, and so I ended up having an amniocentesis just to know what I should prepare myself for. It is one way to know for sure, though I probably overreacted. I like solid answers, though.

A girl! Yay!

[submommy]

My first trip took me to Holland. K. had a surprise birth defect called Atresia/Microtia (related to the ear).

Then, my second trip, R. had the same marker, scaring us into thinking we might be making a visit to a new place we weren't expecting.

It was nothing. And really, after we returned from the ultrasound, we just let the marker sit in the back of our minds and rest, because there were NO OTHER indicators.

He's fine. In fact, we're all fine. I have a feeling baby girl will be too.

[Awesome Mom]

Having these thing spotted (often wrongly) is so much better than having something major missed. My son's heart defect should have been glaringly apparent to any trained technician but it was missed for whatever reason. I was knee deep in all the postpartum hormonal chances when I was told that my son would have to have three lifesaving heart surgeries.

I hope that everything turns up just fine for your little girl.

[jaelithe]

You know, I've never been to Holland instead of Italy. But I did sort of wind up in Spain. And I have to say, Spain is not bad. Oh, it's frustrating sometimes, mind trying to speak Italian to a Spaniard. But the music here is beautiful.

[mothergoosemouse]

I know how reassuring all the ratios and percentages are supposed to be, but I also know how frightening it is to get this news. And how it puts a damper on the shopping.

Take it easy on yourself this weekend, and keep listening to the reassurance. I'll be ready to dish it out anytime you need it.

[TheMama]

I had an Echogenic Cardio - oh my God, WTF moment with my little one too. Along with a week of waiting, the quad screen, and a trip to a hospital 45 minutes away for a second US.

Happily everything turned out fine, and the second doc even said he had no idea what the hell the first tech saw. Thanks a lot, butthead.

It's a weird thing where some kids with Down's have this foci, but the foci does not mean downs.

Essentially more statistical minutia and a lot of CYA guaranteed to make expectant mothers FREAK THE EFF OUT.

I'm with you on the blubbering, having done it myself. I'll jump in with everyone and send you all the good thoughts I can.

Congrats on the girl! From a mom who stands in Target looking at a wall of boy's sneakers and is unreasonably jealous of all the pretty girlie-girl shoes.

[kerry]

Hey there,
I really enjoy your blog. I am a prenatal genetic counselor and these things are my job. I am at home, not work, but as you probably have already found out this ultrasound finding is seen in at least 1-4% of all pregnancies. It is not a birth defect and means nothing functionally for the heart, nor does it require additional follow up once seen. I wouldn't call it a failure of ultrasound per se. It is one soft marker meant to be interpreted in the context of a larger picture encompassing your age, other ultrasound findings, and screening results. By far, the majority of babies with this finding, particularly in the absence of other risk factors (like abnl screening) will be just fine so we are very reassuring about this isolated finding. The quad screen results and extensive ultrasound you have scheduled will likely help reassure you since your baby is probably fine. If you were to walk into my office, I would be very reassuring. Please feel free to email me if you want.
PS - my baby girl had dilated kidneys on ultrasound (another, more concerning soft marker for DS) and she is wonderful, 2 yrs. she does have some low tone issues and delays but is almost caught up with therapies and is amazing. As you know, there are no guarantees in pregnancy, but in terms of things they can pick up on ultrasound, an ECF is probably the least concerning.

[Mrs. Chicken]

Thinking of you.

And today my midwife told me I might need insulin and that how GD can bring about fetal death if I don't control it.

Midwives. Bah.

Hope they get you in soon.

[Kristin]

I am certain that she is fine and beautiful. And she'll certainly be great blog fodder if she's got an ovarian cyst already. Imagine what Junior high school will bring! I wish you and your quad screen the best.

[Lori]

My daughter is six months old & I had the same exact thing happen with my 21 week ultrasound...echogenic cardiac foci. I can't tell you how long I cried even though there was only a 1.3% chance anything would be wrong. We had decided against a quad screen & were very opposed to an amnio, so we waited. The perinatologist did say that anyone could have that marker on their heart...even my husband & I could be standing there with the same marker & not even know it. Thankfully everything turned out fine & my baby was perfectly healthy. Try not to worry, but I know all to well the feelings you are having. I researched this extensively & a lot of dr.'s aren't even using it as a Down Syndrome marker anymore (when it's the only marker)because it's so unreliable. Take care of yourself & your sweet baby on the way. She will be just fine! :)

[Heather]

Lots of hugs and positive vibes coming your way. Just relax and whatever happens she will be perfect!!

[Sara]

My second son's midterm ultrasound showed two markers - echogenic foci and also choriotic (sp?)cysts in the brain. He is absolutely, 100% FINE. So active and smart that I've been known to WISH he was retarded so that he would SIT STILL for two effing minutes. Echogenic foci are also more of an effect of technology than an actual, physically extant thing. Anything that the ultrasound cannot identify shows up as these little white spots. Essentially, failure of the ultrasound is alarming parents nationwide. Additionally, if you had your ultrasound a couple of days earlier or later, they would not even have been there. Seriously. Please don't lose too much sleep over it.

[Amanda]

{{{Hugs}}}

[Crazymommy lady]

From what I understand, the foci are a very, very weak marker without any other markers. So, don't worry, you little girl is just fine.

Tell Q to get the tiaras and hair bows ready - she will have so much fun!