title: Identification and management of fetal isolated right-sided aortic arch in an unselected population.
abstract: OBJECTIVE
  Inclusion of the three vessels and trachea view in the routine assessment of the fetal heart at the 18-20-week morphology scan improves recognition of a right-sided aortic arch (RAA). We report our experience of RAA diagnosed in an unselected population of pregnant women attending for a routine morphology scan.
  
  
  METHODS
  The obstetric imaging databases of two ultrasound centers were reviewed retrospectively to identify all routine fetal morphology scans performed at 18-22 weeks' gestation between January 2011 and December 2014. A review of postnatal charts was conducted to ascertain findings at birth, neonatal complications and the anatomical findings at any neonatal echocardiographic or surgical procedure. Parents of older infants were contacted by phone to assess their wellbeing and identify any respiratory or feeding difficulties.
  
  
  RESULTS
  In the 48-month study period, 43 083 routine anomaly scans were performed. Twenty-three cases of isolated RAA were identified, a prevalence of 0.05%. Nineteen (83%) cases of isolated RAA had a left-sided arterial duct and four (17%) had a right-sided duct. Postnatal follow-up data were obtained in all cases. The prevalence of a symptomatic vascular ring due to a double aortic arch was 13% (3/23). One (4%) case was diagnosed with DiGeorge syndrome.
  
  
  CONCLUSIONS
  RAA can be identified easily on a routine fetal anomaly scan, however the prevalence of RAA is low in an unselected population. Antenatally diagnosed cases should be referred for detailed fetal echocardiography and the patient should be made aware of the association with DiGeorge syndrome and the symptoms associated with a vascular ring. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: Department of High Risk Obstetrics, RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia.|Sydney Ultrasound for Women, Sydney, Australia.|Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine, University of Sydney, Sydney, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Mogra
authors.affiliation: Department of High Risk Obstetrics, RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia.|Sydney Ultrasound for Women, Sydney, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Kesby
authors.affiliation: Department of High Risk Obstetrics, RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia.|Heart Centre for Children, Children's Hospital at Westmead, Westmead, Australia.|Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Sholler
authors.affiliation: Department of High Risk Obstetrics, RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia.|Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine, University of Sydney, Sydney, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Hyett
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000196:embryology*; D001015:Aortic Arch Syndromes / Q000000981:diagnostic imaging / Q000453:epidemiology*; D004062:DiGeorge Syndrome / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis; D015995:Prevalence; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods* / Q000706:statistics & numerical data
keywords: prenatal diagnosis; right aortic arch; ultrasound