Soft Markers on Ultrasound
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, NIH, March of Dimes guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with soft markers on ultrasound, here is what you need to know.
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.
Key takeaways
- 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.
- Usually normal when: An isolated soft marker with normal prenatal screening results
- Call your doctor if: Severe anxiety or distress that is affecting your daily functioning after learning about soft markers
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What Parents Should Know
According to ACOG, NIH, March of Dimes guidelines, 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. At Second trimester, 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. It is generally considered normal when an isolated soft marker with normal prenatal screening results. However, you should contact your pediatrician promptly if severe anxiety or distress that is affecting your daily functioning after learning about soft markers.
Normal vs. Concerning
By Age
What to expect by age
Second trimester
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.
Third trimester
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 to Tell Your Pediatrician
- Describe when you first noticed soft markers on ultrasound and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you want to understand what a specific soft marker means for your baby.
- Mention if multiple soft markers were found.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
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
What You Can Do at Home
- Keep track of when you notice soft markers on ultrasound — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that an isolated soft marker with normal prenatal screening results — this is generally within the range of normal.
- At Second trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if severe anxiety or distress that is affecting your daily functioning after learning about soft markers.
Related Conditions
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.
Related Resources
Frequently asked questions
Is soft markers on ultrasound normal?
When should I call the doctor about soft markers on ultrasound?
When is soft markers on ultrasound normal?
What causes soft markers on ultrasound?
What should I mention to my pediatrician about soft markers on ultrasound?
Is soft markers on ultrasound normal at Second trimester?
Is soft markers on ultrasound normal at Third trimester?
Should I go to the ER for soft markers on ultrasound?
Does soft markers on ultrasound go away on its own?
References
- [1]American College of Obstetricians and Gynecologists. Screening for Fetal Chromosomal Abnormalities. ACOG Practice Bulletin No. 226, 2020. ACOG
- [2]National Library of Medicine. Ultrasound Soft Markers in Prenatal Screening. StatPearls, 2023. NIH
- [3]March of Dimes. Prenatal Tests. March of Dimes, 2023. March of Dimes
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Soft Markers on Ultrasound.
Things to mention
- Describe when you first noticed soft markers on ultrasound and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you want to understand what a specific soft marker means for your baby.
- Mention if multiple soft markers were found.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- 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
Urgent signs to report immediately
- Severe anxiety or distress that is affecting your daily functioning after learning about soft markers
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
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Related Resources
Bottom line
Most cases of soft markers on ultrasound are normal. Talk to your pediatrician if severe anxiety or distress that is affecting your daily functioning after learning about soft markers.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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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.
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