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- W1970213088 abstract "We aimed to determine the frequency, prenatal characteristics and outcome of ‘normal hearts’ in left isomerism (L-iso) which is often associated with major congenital heart disease (CHD) and guarded outlook. Retrospective review of all cases of L-iso detected by fetal echo (FE) in 1997–2007. Diagnosis was based on a combination of interrupted inferior vena cava (IVC), cardiac/visceral malposition, CHD and heart block. Indications for FE, presence of CHD, extracardiac abnormalities and outcome were noted. Nineteen cases were diagnosed at a median age of 23 weeks' gestation (range, 11–31). Main indications for FE were suspected CHD (n = 8), abnormal stomach position (n = 5) and dysrhythmia (n = 3). Five mothers had diabetes. Azygos continuation to an IVC was observed in 16 cases at > 18 weeks but could not be seen in three cases at < 13 weeks. The stomach was right-sided in nine and central in two. The heart/apex position was abnormal in four. Polyhydramnios developed in three fetuses. No-major-CHD group: Eight fetuses (42%) had a normal heart (left-sided in all, abnormal stomach position in five). Seven were born alive, six are healthy children. There was one perinatal death due to placenta abruption. One ongoing pregnancy shows evidence of upper gastrointestinal (GI) obstruction. Major-CHD group: Eleven (58%) had CHD, four with a univentricular atrioventricular (AV) connection. Other findings included: AV septal defect (n = 7), double outlet right ventricle (n = 4) and single outlet (n = 3). There were five terminations (one with a cerebrospinal defect), one intrauterine death and four live births. One child required GI surgery. Five fetuses had bradycardia. One pregnancy is ongoing. A significant proportion of fetuses with prenatal diagnosis of L-iso have a normal heart and good outcome. Postnatal monitoring is required for potential GI and rhythm complications. The first step to their correct prenatal identification is ascertainment of fetal laterality, situs and visceral position." @default.
- W1970213088 created "2016-06-24" @default.
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- W1970213088 date "2007-09-21" @default.
- W1970213088 modified "2023-09-27" @default.
- W1970213088 title "OP06.12: Left isomerism in the fetus: is it always bad news? Frequency and outcome of cases with ‘normal hearts’" @default.
- W1970213088 doi "https://doi.org/10.1002/uog.4456" @default.
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