Two cases of fetal myocardial calcification confirmed postnatally are
reported. In contrast to other reports, both infants survived with res
olution of calcification by 6 and 12 months. Diagnostic investigations
failed to confirm the presence of congenital infection. Both pregnanc
ies were complicated by early cocaine use leading to the speculation t
hat myocardial necrosis with subsequent calcification related to the t
oxic and/or vascular effects of cocaine was responsible. The finding o
f fetal myocardial calcification on prenatal ultrasound should prompt
a search for causes, which may include cocaine exposure.