Clinical implication of isolated right dominant heart in the fetus.
OBJECTIVE
To evaluate the clinical implication of isolated right dominant heart (RDH) in fetal echocardiography.


METHODS
We reviewed the medical records of pregnant women diagnosed with fetal RDH at Asan Medical Center from December 1999 to December 2005. The criteria of RDH were the ratio of right-to-left atrial and ventricular width and the ratio of the diameter of pulmonary artery-to-aorta were greater than 1.5. Fetuses with congenital heart disease, including coarctation of the aorta (CoA), noncardiac anomalies or chromosomal abnormalities were excluded.


RESULTS
RDH was identified in 44 fetuses. Twenty-nine (66%) were confirmed to have normal heart and 15 (34%) had cardiac anomalies by postnatal echocardiogrphy; 11 CoA, 1 interruption of aortic arch, 1 patent ductus arteriosus, and 2 ventricular septal defect. Mean gestational age at presentation with RDH was later in normal fetuses as compared to fetuses with CoA (p < 0.005). Only 26% (4/15) of fetuses presenting with RDH during the second-trimester were found to have normal heart postnatally, compared with 86% (25/29) of those diagnosed in the third-trimester.


CONCLUSIONS
RDH in the fetus is a risk factor for postnatal CoA particularly when diagnosed in the second-trimester, and should be an indication for neonatal echocardiography.
Jung
Eui
E
Department of Obstetrics and Gynecology, College of Medicine, KyungHee University, Seoul, Korea.
Won
Hye-Sung
HS
Lee
Pil Ryang
PR
Kim
Ahm
A
Park
In-Sook
IS
D000328:Adult; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000196:embryology* / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D005318:Fetal Heart / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005865:Gestational Age; D006325:Heart Atria / Q000002:abnormalities / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D016216:Ultrasonography, Prenatal