Soft Markers on Ultrasound
The short answer
Soft markers are minor ultrasound findings that are usually variants of normal but may slightly increase the statistical risk of chromosomal conditions. Common soft markers include echogenic intracardiac focus (bright spot on heart), choroid plexus cysts (small cysts in the brain), and mild pyelectasis (slightly dilated kidneys). An isolated soft marker (one finding with no other concerns) is usually not significant.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
Soft markers are typically found during the anatomy scan. An isolated soft marker (single finding) in a low-risk patient with normal screening results has minimal clinical significance. Multiple soft markers or a soft marker combined with abnormal screening results may warrant further evaluation. Your provider may recommend genetic counseling to help interpret findings in the context of your overall risk.
Follow-up ultrasounds may show that soft markers have resolved. Choroid plexus cysts, for example, almost always disappear by the third trimester. If prenatal screening was normal and the soft marker was isolated, the reassurance value is high. Most babies with isolated soft markers are completely healthy.
What Should You Do?
When to take action
- An isolated soft marker with normal prenatal screening results
- Soft markers that resolve on follow-up ultrasound
- Anxiety about soft markers - this is a very normal reaction to unexpected news
- You want to understand what a specific soft marker means for your baby
- Multiple soft markers were found
- You want to discuss whether additional testing is recommended
- Severe anxiety or distress that is affecting your daily functioning after learning about soft markers
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Maternal Concerns
20-Week Anatomy Scan Unexpected Findings
The 20-week anatomy scan checks your baby's major organs, structures, and growth. Most scans are completely normal. When unexpected findings are identified, they range from minor variants that resolve on their own to conditions that need further evaluation. Many findings require nothing more than a follow-up ultrasound to confirm the baby is developing well.
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Two-Vessel Cord (Single Umbilical Artery)
A single umbilical artery (SUA), also called a two-vessel cord, occurs when the umbilical cord has one artery instead of the typical two. It is found in about 1% of pregnancies. An isolated SUA (with no other abnormalities) is usually not a cause for concern, and most babies with an isolated SUA are born healthy.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.
Less Movement with Anterior Placenta
An anterior placenta (attached to the front wall of the uterus) acts as a cushion between the baby and your belly wall, which can make movements feel muffled or less intense. You may feel movement later (22-24 weeks instead of 18-20) and primarily on the sides and lower belly. This is normal, but you should still feel regular movement once it is established.