Objective
How to distinguish right from the left side of the fetus and what is the difference between dextrocardia and dextroposition of the heart? The aim of the study, prepared by the Student`s Scientific Club, was to evaluate the prevalence of the abnormal position and/or the axis of the fetal heart.
Material and methods
Retrospective evaluation of 42 fetuses between 2004-2008 whose heart was shifted to the right. The reason for referral was: abnormal heart view, abnormal US or different fetal malformations. The mean age of fetal echo was 24 (dextrocardia) and 30,5 (dextroposition) weeks.
Results
Dextroposition (shifting of the heart to the right, apex to the left) was found in 35(83%) fetuses. 30(85%) fetuses had left-diaphragmatic hernia (DH), 3(9%)-congenital cystic adenomatoid malformation (CCAM), 1(3%) - pleural effusion, 1(3%) - left pulmonary artery agenesis. Secondary hypoplasia of the left heart due to DH was seen in 4 cases. In 9 fetuses extracardiac malformations existed: hypotrophy 4, cleft-lip 1, shortening of the long bones 1, myelocystocele 1.
Dextrocardia (apex to the right) was found in 7(17%) fetuses, all with CHD: 1(14%) situs inversus (SV, TGA); 6 (86%) situs solitus: right isomerism - 1 (AVSD,AP), left isomerism - 1 (TGA,VSD,PS), SV - 1, HLHS - 1, other - 2.
Conclusion
Dextroposition is more common than dextrocardia, due to extracardiac malformations. Dextrocardia was much less frequent and was associated with multiple and complex congenital cardiac anomalies. It was difficult to distinguish between dextrocardia and dextroposition during a screening US exam.