Oztunc Funda, Madazli Riza, Yuksel Mehmet Aytac, Gökalp Selman, Oncul Mahmut
Department of Pediatrics, Cardiology Unit and.
J Matern Fetal Neonatal Med. 2015 Jun;28(9):1104-7. doi: 10.3109/14767058.2014.943659. Epub 2014 Jul 28.
To evaluate the incidence, associated cardiac and extracardiac malformations and clinical outcome of fetuses with dextrocardia.
A retrospective review of 3556 fetal echocardiograms between 2000 and 2011 revealed 39 cases of dextrocardia. Dextrocardia was defined as right-sided positioning of the fetal heart. Prenatal and postnatal records of the fetuses were reviewed.
The incidence was 1.1%. Of the 39 fetuses, 22 were primary dextrocardia and 17 were dextroposition. Diaphragmatic hernia was the most common cause of dextroposition with the incidence of 76%. Of the fetuses with dextroposition 35.5% had a cardiac anomaly. The survival rate of dextroposition was 31.2% and none of the survivors had an associated cardiac anomaly. Primary fetal dextrocardia was most common with situs solitus (45.4%), followed by situs ambiguous (36.3%) and then situs inversus totalis (18.1%). Structural cardiac malformations were found in 100%, 80% and 25% of fetuses with situs ambiguous, solitus and inversus, respectively. Of the dextroposition, 47.6% terminated pregnancy, 14.2% resulted in intrauterine death, 9.5% died after birth, and 28.5% survived.
A wide spectrum of complex cardiac malformations are associated with fetal dextrocardia. Fetal echocardiography enables detection of complex cardiac anomalies so that parents can be appropriately counselled.
评估右位心胎儿的发病率、相关心脏及心脏外畸形情况以及临床结局。
回顾性分析2000年至2011年间3556例胎儿超声心动图，发现39例右位心。右位心定义为胎儿心脏位于右侧。对这些胎儿的产前和产后记录进行了回顾。
发病率为1.1%。39例胎儿中，22例为原发性右位心，17例为心脏右移。膈疝是心脏右移最常见的原因，发病率为76%。心脏右移的胎儿中35.5%有心脏异常。心脏右移胎儿的存活率为31.2%，且存活者均无相关心脏异常。原发性胎儿右位心中最常见的是心房正位（45.4%），其次是心房异构（36.3%），然后是全内脏反位（18.1%）。心房异构、正位和反位的胎儿中分别有100%、80%和25%存在心脏结构畸形。心脏右移的胎儿中，47.6%终止妊娠，14.2%发生宫内死亡，9.5%出生后死亡，28.5%存活。
多种复杂的心脏畸形与胎儿右位心相关。胎儿超声心动图能够检测出复杂的心脏异常，从而可为父母提供适当的咨询。
