Journal of Ultrasound in Medicine, Vol 19, Issue 10 669-676, Copyright © 2000 by American Institute of Ultrasound in Medicine
Fetal cardiac dextroposition in the absence of an intrathoracic mass: sign of significant right lung hypoplasia
M. M. Abdullah, R. V. Lacro, J. Smallhorn, D. Chitayat, M. E. van der Velde, S. J. Yoo, L. Oman-Ganes and L. K. Hornberger
Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children and the University of Toronto, Ontario, Canada.
We reviewed our experience of fetal cardiac dextroposition in the absence
of an intrathoracic mass. Ten cases were found by fetal echocardiography to
have a normal cardiac axis, but the heart was shifted into the right chest
and the amount of right lung tissue was reduced. At birth seven of the
infants had confirmed structural heart disease (70%), including three with
scimitar syndrome. Two infants had additional extracardiac anomalies (20%).
Seven infants born at term had clinical pulmonary hypertension with a
diagnosis of right lung hypoplasia in all of them. Two neonates died owing
to significant heart disease (one with scimitar syndrome and the other with
hypoplastic left heart syndrome). Of the three pregnancies that were
terminated, the two fetuses with autopsies had severe right lung
hypoplasia. Fetal cardiac dextroposition and right pulmonary artery
hypoplasia in the absence of an intrathoracic mass are important signs of
right lung hypoplasia, which can be associated with significant pathologic
cardiac and extracardiac conditions.
