09/12/2025
Fetal echo 24 weeks, 24Y female, primigravida with no h/o abortion or rash
4 chamber evaluation showed bradycardia (FHR ranging between 90-100), poor ventricular contractility and pericardial effusion,
Detailed chamber evaluation showed echogenic walls of left atrium, pulmonary veins, LVOT and interatrial septum. There was restricted flow across foramen ovale (diameter 1.8mm, cutoff-3 mm) with resultant dilatation of right sided chambers.
Diagnosis: Fetal Endocardial Fibroelastosis.
Foetal Endocardial Fibroelastosis (EFE) is a rare cardiac disorder, (1 in 6000 births) characterised by echogenic thickening of the endocardium and decreased ventricular contractility, secondary to proliferation of elastic and collagen fibres.
Causes include stress, deposition of maternal autoantibodies (antiRO, antiLA) and certain viral infections
Treatment includes steroids and IVIG
Prognosis is guarded.
