Twins: Echogenic Intracardiac Focus

Echogenic foci, left ventricle:  That’s what was written in the ultrasound report.  One of our twins had it.  “What the heck is an echogenic foci?”  “Oh, that’s nothing, don’t mind that.”  That’s what the technician told us at the 20 week ultrasound.  So I didn’t worry about but soon after, it would haunt us.

I did not share this story to many.  At the time, it was too difficult for me to write.  I am now ready to share this to others, to maybe help give a drop of hope to others, to help put a smile to others who may be sharing the same news or similar.  I hope from this true story, we realize life is crazy at times but in the end, it works out; some how, some way.  It always does, eventually.

20 week ultrasound

Our story starts with the 20 week ultrasound of our twins and I remember saying to myself, “The 20 week ultrasound should be exciting.”  But it wasn’t.  You know, you’re suppose to find out the sex of the baby, see their fingers, toes, limbs and hear the heart.  At the end of it, the report showed in hand writing, “echogenic foci”. 

Doctor’s office

“Everything looks good but I have to tell you this….”  I wasn’t with my wife when she heard the news.  I heard the news when my wife called me at work….” Quynn….echogenic foci….down syndrome”  That’s all I could make from my wife who was crying on the other end.

Echogenic Intracardiac Focus (EIF)

So now here’s the science lesson for today.  Echogenic Intracardiac focus is a bright spot found on the heart of a baby during the ultrasound.  I remember seeing it.  It was a small dot and white on the heart.  It’s a calcium deposit on the heart muscles and it occurs in 3-5% of pregnancies.  Alone, it has no impact on the function of the heart.  The bad new is, some say there is a link to DS or birth defects.  The main ones are trisomy 18 and trisomy 23.  In an isolated case of EIF, meaning no other findings were found, the increased risk of chromosomal abnormalities is approximately twice.  So if you baby’s chance of having a birth defect is 1/1400, and only an EIF was discovered, the risk becomes 1/700.  I also read it occurs more in the Asian population than any other.  You can’t believe everything you read but you can imagine the emotions that were to follow.

The Next 18 Weeks

I think we cried a lot, prayed a lot, asked a lot of “why” questions.  But for the next 18 weeks we lived with the unknown.  Would Quynn be born with a birth defect?  Jayde’s report did not uncover anything unusual thankfully.  There were nights I just stood out in my backyard, looking at the stars and wondering, “What does life have to offer”  I stood for minutes wondering, “Can I handle a DS kid.”  It was hard, my heart and stomach were in knots everyday.  We were offered genetic counseling to help us in our decisions.

Genetic Counseling

You think getting an appointment with your doctor is hard, try getting one with genetic counseling.  We had a small window of opportunity and I remember immediately rushing down to North York General when it opened up.  God, we were so stressed.  We didn’t know what to expect and what could we possibly do at 22 weeks now.  We walked into Genetics and it was a deserted island ‘cause there wasn’t anyone there.  No one at front desk, no one waiting, just empty chairs.  

We waited almost an hour before we saw the counselor.  She was nice and understood the sensitive topic.  She explained to us the echogenic focus in the left ventricle thing again, but by that time we were experts.  She gave us the statistics and our chances of having a Down syndrome baby.  I think the worst case was 1/300 and best case was 1/700.  But who cares, it was just numbers, and numbers tend to lie.  What they couldn’t tell us, “Does Quynn have down syndrome?”  So she offered us amniocentesis to truly find out.  That would mean sticking two needles into the belly, one for both fetuses.  Then she mentioned the chance of losing both babies were 1/100 to 1/150 for the amnio.  I hate stats and I’m not a gambling man, but that sure sounds terrible. 

So it was either do the amnio which would have to be in the next couple days because they only do it Thursday mornings, and we can only abort the baby up to the 23^rd week or, do nothing. We basically only had a 2 days to decide what to do.  Do nothing, we said, and let life take its course.  God brought us this far in life, he will surely guide us the rest of the way.  We decided we would love our children either way.  From the genetic counseling we made our decision and I felt better.

38 weeks

That’s when my wife gave birth to 2 girls.  Jayde was born first and then Quynn 2 minutes later.  Up to this point, I still thought about the echogenic foci and DS but I remembered I had left that decision to God and put it in His hands by then.  When Quynn came out, I didn’t get to see her right away since they swiftly whisked her away.  A couple minutes later, a door opened and there stood a nurse with only one baby in her arms.  “Do you want to hold her,” she asked.  “Yes.” I replied.  I held the tiny creature and looked at her.  Her eyes were open, her face was round, and her tiny lips were still.  She just looked at me, not saying a word.  “She’s Baby B,” said the nurse.  “Do you have a name for her yet?”  “It’s Quynn Riley”, and it was at that moment when I felt God saying to me, “You’re going to be okay, and she’s going to be all right.”  I will never forget that feeling.  I will take that memory to my grave.

In the end

During the whole pregnancy, we didn’t know what’s going to happen.  It really made me think, do you believe in what you’ve said you believe in all this time?  When faced with hardship, are you going to run for the hills?  So many things can just go wrong in this life.  Sometimes they do, but a lot of the times they don’t.  We are lucky and blessed.  I think I’ve said it before but I’ll say it again, I don’t need to win the lottery because I already won in this life.