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Case Reports
. 2013 Jul;23(3):262-5.
doi: 10.4103/0971-3026.120266.

Increased fetal endocardial echogenicity mimicking endocardial fibroelastosis following maternal organophosphorus poisoning and its complete regression in utero

Karippaliyil Balakumar  1 , Kannan Misha  1 , Karippaliyil Milind  1
Affiliations
Case Reports

Increased fetal endocardial echogenicity mimicking endocardial fibroelastosis following maternal organophosphorus poisoning and its complete regression in utero

Karippaliyil Balakumar et al. Indian J Radiol Imaging. 2013 Jul.

Abstract

Fetal endocardial fibroelastosis (EFE) has been diagnosed by antenatal ultrasonography in the past few years. A typical case of isolated endocardial fibroelastosis is illustrated here, in a fetus of 22 weeks of gestational age exposed to maternal organophosphorus poisoning at 20 weeks. No other structural cardiac or other systemic anomalies were detected in this fetus. The abnormal fetal echocardiographic features mimicking endocardial fibroelastosis completely regressed after 14 weeks and a normal full-term baby was delivered. Postnatal echocardiogram showed normal cardiac parameters. The diagnostic features mimicking EFE following maternal organophosphorus poisoning at 20 weeks of gestational age and the subsequent complete reversal of these changes after 14 weeks of diagnosis are reported for the first time in the literature.

Keywords: Fetal anomaly; fetal cardiac anomaly; fetal cardiomyopathy; fetal echocardiography; fetal endocardial fibroelastosis; fetal organophosphorus poisoning.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Slightly oblique short axis view of the fetal heart at 22 weeks of gestation shows the “pearly white” endocardium of ventricles (RV: Right ventricle, LV: Left ventricle) and interventricular septum (IVS)
Figure 2
Figure 2
Magnified view of the interventricular septum shows the hyperechogenicity of the endocardial surfaces (APX: Cardiac apex, RV: Right ventricle, LV: Left ventricle)
Figure 3
Figure 3
The 4-chamber view shows the hyperechoic endocardium extending along the crux and the mitral leaflets. The hyperechoic mitral leaflets are opening into the left ventricle (LV: Left ventricle, RV: Right ventricle, LA: Left atrium, RA: Right atrium)
Figure 4
Figure 4
Magnified view of the mitral leaflets shows the rolled tips within the left ventricle (LV: Left ventricle, RV: Right ventricle, LA: Left atrium, RA: Right atrium)
Figure 5
Figure 5
The outflow tracts show normal calibre and flow (APX: Cardiac apex, RV: Right ventricle, LV: Left ventricle, AO: Aorta, PA: Pulmonary artery)
See this image and copyright information in PMC

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