Clinical and ultrasonographic features of dextroposition of the fetal heart

OBJECTIVE: Our purpose was to characterize the findings associated with dextroposition of the fetal heart. STUDY DESIGN: A fetal echocardiography database was retrospectively searched from January 1990 through December 1996 to identify all cases referred or diagnosed with dextroposition of the fetal heart. Dextroposition was defined as most of the normally connected fetal heart found on the right side of the fetal chest. Intracardiac and extracardiac fetal anomalies were reviewed. All available karyotypes and postnatal examinations were reviewed. RESULTS: During the study period 2882 fetal echocardiograms were performed, of which 297 (10.3%) were abnormal. Of these, 14 had dextroposition. Associated anomalies included atrioventricular canal (29%), diaphragmatic hernia (21%), and aneuploidy (14%). isolated dextroposition with no other significant anomalies was seen in only 1 case. In another, no anomalies were noted except for suspected agenesis of 1 robe of the right lung; karyotype and postnatal evaluation revealed no other abnormalities in both cases. CONCLUSIONS: Dextroposition of the fetal heart was seen in 0.5% of our fetal echocardiograms and was associated with significant anomalies in 86% of our cases. When diagnosed, a targeted ultrasonogram, fetal echocardiogram, and karyotype should be offered.