Journal of Ultrasound in Medicine, Vol 10, Issue 10 539-546, Copyright © 1991 by American Institute of Ultrasound in Medicine
Sonographic spectrum of fetal cardiac hypoplasia
J. P. McGahan, M. Choy, M. D. Parrish and W. E. Brant
Department of Radiology, University of California, Davis Medical Center, Sacramento 95817.
Four cases of hypoplastic left ventricle and three cases of hypoplastic
right ventricle detected sonographically prenatally are presented. A
four-chamber view of the heart was abnormal in all seven cases. The
sonographic appearance of the hypoplastic ventricle was variable, being
smaller than normal in six of seven cases and not being identified at all
in one case. Other ultrasound findings included an atrial septal defect (n
= 7); increased size of the contralateral ventricle (n = 6);
nonvisualization or poor visualization of the outflow tract of the affected
ventricle (n = 6), and intact ventricular septum (n = 5). In one of four
cases of hypoplastic left ventricle the pregnancy was terminated; the other
three infants died within 5 days after birth. One of the three fetuses with
hypoplastic right ventricle was aborted. Of the remaining two infants
included one had tricuspid atresia with a ventricular septal defect and one
had pulmonary atresia with an intact ventricular septum. Both infants are
alive, have had palliative surgery, and will be considered for a more
definitive surgical repair. An abnormal four-chamber view of the heart
should alert those performing routine obstetrical ultrasound to a possible
hypoplastic ventricle, so that the pregnant woman can be referred to a
center capable of performing more sophisticated fetal echocardiography.
