Conditions in Pregnancy Anemia When your hemoglobin/hematocrit is <11mg/dL/33%, the World Health Organization defines you to be anemic. Essential Facts About Anemia Anemia is most often secondary to inadequate iron intake. The typical U.S. diet contains about 18mg of iron a day of which only 1mg is absorbed. Each pregnancy depletes maternal iron stores by 750mg. Anemia May Cause Fatigue Depression Shortness of breath Low blood pressure Heart palpitations (pounding) Increased risk of blood transfusion during delivery Foods and Drugs That Don’t Mix Well with Iron Foods high in phytic acids (grains, seeds, legumes) decrease iron absorption. Dairy products decrease bioavailability of iron. Iron supplements should not be taken within one hour of consuming dairy products. Thyroid supplements should be taken four hours apart from iron supplements to maximize the effectiveness of thyroid supplementation. Proton pump inhibitors (Prevacid, Prilosec OTC, etc.) reduce the bioavailability of iron. Calcium, aluminum, and magnesium decrease iron absorption. Therefore, iron should be taken at least one hour before or two hours after products containing these chemicals. Simple Remedies Remember to take your prenatal vitamin daily. Vitamin C and folic acid help increase iron stores. Echogenic Intracardiac Focus (EIF) EIF at a glance An echogenic intracardiac focus (or EIF) is a small bright spot seen in a baby’s heart during a prenatal ultrasound in the second and third trimester. The cause of EIF is unknown, but the condition is generally harmless. EIF is considered a normal pregnancy variation, but prenatal screening tests may be desirable to test for any abnormalities. EIF prenatal ultrasound findings During the second trimester of pregnancy a prenatal ultrasound is performed to examine your baby’s anatomy, including the heart. This will evaluate the four normal chambers of the heart: the right atrium and ventricle, and left atrium and ventricle. Sometimes, one or more small bright spots are seen in one of the baby’s heart chambers, most frequently in the ventricles, or pumping chambers. This is commonly referred to as an EIF (echogenic intracardiac focus) or echogenic foci (plural). This is a common finding on ultrasounds, seen in about 3 percent to 5 percent of pregnancies. An EIF does not generally impact the overall health of the baby or the development of his or her heart. Most EIF seen in the middle of the pregnancy will not go away before delivery. Since they do not cause problems for the baby, additional ultrasounds to follow-up on the EIF are not needed unless other findings were noted or we were not able to evaluate the anatomy completely. Causes of EIF Why EIF is seen in some babies and not others is not known. Some doctors think that the bright spot is due to an area of the heart muscle where more calcium than average has collected. On ultrasound, areas with more calcium (such as in bones) cause the sound waves to respond with a brighter appearance on the screen. Risks of EIF Most of the time, EIF is seen during a routine prenatal ultrasound performed around weeks 8-20 of the pregnancy. While it is impossible to be completely certain that no birth defects are present in the baby, most pregnancies with isolated ElF (no other abnormal ultrasound findings) will result in a healthy baby. ElF is considered a normal variation in fetal development and has not been found to cause any long-term health problems or heart problems for the baby. EIF is more frequently found in babies whose mothers have Asian ancestry. However, it can be seen in any pregnancy, regardless of race. Although the EIF doesn’t cause problems for the baby, some studies have suggested there could be a slightly increased risk for Down syndrome when this ultrasound finding is present. However, not all studies agree that there is any connection to Down syndrome. Are additional tests needed? There is no special testing recommended for pregnancies found to have an isolated EIF. However, in any pregnancy, women are offered optional prenatal tests that can help find specific kinds of birth defects, including Down syndrome. There are two kinds of prenatal tests available, screening tests and diagnostic procedures. Prenatal screening tests can help find out if there is a higher or lower chance of having a baby with a certain problem. Prenatal diagnostic procedures can accurately identify certain problems present with the baby. Amniocentesis is a diagnostic procedure available until about 22 weeks of pregnancy for prenatal diagnosis of chromosome abnormalities. This is not recommended for an isolated EIF finding unless prior screening indicates an increased risk for chromosomal abnormalities. This article is not intended to provide specific medical advice and is not to be used or relied on for diagnostic or treatment purposes. Rather, this article is provided as an information resource only to help you better understand your health. It does not create any patient-physician relationship. You are urged to consult with a qualified physician for specific medical advice, diagnosis and treatment and for answers to your personal medical questions.