Patient: Description (time of onset, main symptoms, hospital visited, etc.): prenatal screening at 18 weeks of pregnancy, low risk, prenatal ultrasound at 25 weeks of pregnancy, ultrasound indicates “intrauterine pregnancy, single live fetus, roa, fetal size equivalent to 25 weeks and 3 days, placenta grade 0, marginal placenta cord entry, amniotic fluid index 136mm, fetal left ventricle strong spot sonogram (size 2.5x2mm, 2x2mm). (2.5x2mm and 2x2mm respectively) Please help me to see this result and help me to answer the question: what do I have to do? What do the two strong spots in the left ventricle mean? Thank you, I look forward to your reply! Sun Lumen, Department of Obstetrics, Shanghai First Maternal and Child Health Hospital: Ventricular strong light spots are spots of strong echogenicity found in the area of the ventricular myocardial papillary muscle, with echogenicity higher than or equal to that of the surrounding bone tissue, mostly calcification of the corresponding area of the myocardial papillary muscle, mostly as a normal physiological manifestation. Most of them occur in the left ventricle, but they can also occur in the right ventricle or in both ventricles at the same time. Some literature has reported an association between ventricular glare and fetal chromosomal lesions, but if the risk is low on Down’s screening and no other structural or genetic marker abnormalities are detected on ultrasound, this risk is low and is not an indication for chromosomal testing. However, it is also believed that if the glare occurs in both ventricles, or appears in the right ventricle, or if multiple glare spots are found, karyotyping is still recommended. Isolated ventricular glare points do not indicate a structural problem in the heart and are not relevant. It is not an indication for an echocardiogram. It is recommended to see your local doctor to give you an individualized consultation based on your serum screening results, ultrasound results. Patient: Thank you for your guidance Patient: Dr. Sun, for the serum screening you are instructing, is the cord blood or my blood being drawn? What are the main items of serum screening? I look forward to your reply! The serologic screening test in the middle of pregnancy is performed by drawing maternal serum for B-hCG and alpha-fetoprotein levels at 15-20 weeks of gestation to assess the risk of trisomy 21 and neural tube defects in the fetus. If you have not had this screening test, it can only be assessed based on your age. Your age is 31 years old and you have a combination of two strong spots in the left heart, I would recommend a fetal chromosome test. At your gestational age, you may be considered for an umbilical cord puncture at 25 weeks of gestation to extract umbilical cord blood for fetal karyotype analysis. Or do an amniocentesis to extract amniotic fluid for a rapid diagnosis of common chromosome number abnormalities using FISH technique. Patient: Thank you for your prompt reply. I had my serum test at 18 weeks of pregnancy, called midtrimester screening, I think, for trisomy 21 and neural tube defects, which you mentioned. My test result was low risk. Sun Lumen, Department of Obstetrics, Shanghai First Maternal and Child Health Hospital: It has been reported in the literature that there is a relationship between ventricular glare and fetal chromosomal lesions, but if the risk of Down’s syndrome is low and no other structural or genetic marker abnormalities are found on ultrasound, the risk is very low and is not an indication for chromosomal testing. However, it is also believed that if the glare occurs in both ventricles, or appears in the right ventricle, or if multiple glare spots are found, karyotyping is still recommended.