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Comparative Study
. 2017 Nov 23;17(1):393.
doi: 10.1186/s12884-017-1579-y.

Comparing levocardia and dextrocardia in fetuses with heterotaxy syndrome: prenatal features, clinical significance and outcomes

Xiaofang Wang  1 , Yifan Shi  1   2 , Shi Zeng  1 , Jiawei Zhou  1 , Jia Zhou  1   3 , Hongxia Yuan  4 , Lin Wang  5 , Weiyuan Shi  2 , Qichang Zhou  6
Affiliations
Comparative Study

Comparing levocardia and dextrocardia in fetuses with heterotaxy syndrome: prenatal features, clinical significance and outcomes

Xiaofang Wang et al. BMC Pregnancy Childbirth. .

Abstract

Background: To investigate the differences in cardiovascular disease, extracardiac anomalies and outcomes between fetuses with levocardia and dextrocardia.

Methods: Clinical demographics, prenatal features, postnatal characteristics and the outcomes of fetuses with levocardia or dextrocardia were recorded and analyzed.

Results: Sixty-five fetuses with dextrocardia and thirty-eight fetuses with levocardia were enrolled. Right ventricle outlet obstruction, atrioventricular septal defect and intestinal malrotation were common in both groups. Univentricular physiology, transposition of the great arteries and esophageal atresia were more frequent in fetuses with levocardia, whereas abnormal pulmonary venous connection, double outlet of right ventricle, left ventricle outlet obstruction and brain abnormalities were more frequent in the dextrocardia group. The accuracy of evaluating cardiac malformations was high, but the sensitivity in assessing extracardiac abnormalities was low.

Conclusions: Although the disorders have certain overlapping features, there are several differences between fetuses with levocardia and dextrocardia. These findings might improve patient counseling and perinatal management.

Keywords: Dextrocardia; Heterotaxy; Levocardia; Prenatal diagnosis.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the ethics committee of The Second Xiangya Hospital of Central South University in China, the Chenzhou No.1 People’s Hospital in China, and the First Affiliated Hospital of University of South China, Maternal & child health center of Changsha and Zhuzhou. Written informed consent was obtained from all of the families.

Consent for publication

Written informed consent was obtained from parents for publication of clinical details, clinical images.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
US show a fetus at the gestational age of 21.1 weeks with levocardia. The heart is located in the normal levo position with a left-sided cardiac apex (shown on a). The stomach is located in the right side of the abdomen (shown in b)
Fig. 2
Fig. 2
US shows a fetus at the gestational age of 22.7 weeks with dextrocardia. The heart is located in the right hemithorax with the heart axis directed to the right and caudad (shown on a). The stomach is located in the left side of the abdomen (shown in b)
Fig. 3
Fig. 3
A 22.3-week gestational age fetus with levocardia and esophageal atresia. A cystic dilated esophagus was observed during fetal ultrasound screening (a), and autopsy confirmed esophageal atresia (b)
Fig. 4
Fig. 4
A 24-week gestational age fetus with dextrocardia and intestinal atresia. A dilated jejunum and duodenum were seen during fetal ultrasound screening (a), and autopsy confirmed intestinal atresia (b)
See this image and copyright information in PMC

References

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