Article Text

Download PDFPDF
Fetal dextrocardia: diagnosis and outcome in two tertiary centres
  1. A Bernasconi1,
  2. A Azancot1,
  3. J M Simpson2,
  4. A Jones2,
  5. G K Sharland2
  1. 1Fetal Cardiology Unit, Hôpital Robert Debré, Paris, France
  2. 2Fetal Cardiology Unit, Guy’s Hospital, London, UK
  1. Correspondence to:
    Dr Annabelle Azancot
    Fetal Cardiology Unit, Hôpital Robert Debré, Paris, France; annabelle.azancotrdb.ap-hop.paris.fr

Abstract

Objective: To evaluate the incidence of fetal dextrocardia, associated cardiac and extracardiac malformations, and outcome.

Design: Retrospective echocardiographic study.

Setting: Two tertiary centres for fetal cardiology.

Patients: 81 consecutive fetuses with a fetal dextrocardia presenting at Guy’s Hospital, London, between 1983 and 2003 and at Hôpital Robert Debré, Paris, between 1988 and 2003. Fetal dextrocardia was defined as a condition in which the major axis of the heart points to the right.

Results: The incidence was 0.22%. There were 38 fetuses (47%) with situs solitus (SS), 24 (30%) with situs ambiguus (SA), and 19 (23%) with situs inversus (SI). Structural cardiac malformations were found in 25 cases (66%) of SS, 23 cases (96%) of SA, and 12 cases (63%) of SI. Extracardiac malformations were identified in 12 cases (31%) of SS, in five cases (21%) of SA, and in two cases (10%) of SI. Of the 81 cases of fetal dextrocardia, there were 27 interrupted pregnancies (15 of 24 SA, 10 of 38 SS, and 2 of 19 SI), six intrauterine deaths (3 of 38 SS, 2 of 24 SA, and 1 of 19 SI), and five neonatal deaths (3 of 24 SA, 1 of 19 SI, and 1 of 38 SS). There were 43 survivors (24 of 38 SS, 15 of 19 SI, and 4 of 24 SA).

Conclusion: The majority of fetuses with dextrocardia referred for fetal echocardiography have associated congenital heart disease. There is a broad spectrum of cardiac malformation and the incidence varies according to the atrial situs. Fetal echocardiography enables detection of complex congenital heart disease so that parents can be appropriately counselled.

  • SA, situs ambiguus
  • SI, situs inversus
  • SS, situs solitus
  • VATER, vertebral, anal, tracheal, esophageal, and radial anomalies
  • fetal dextrocardia
  • fetal heart
  • cardiac malformations
  • extracardiac malformations
  • outcome

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes