Prenatal diagnosis, management, and postnatal outcome of a fetus with massive cardiomegaly secondary to placenta chorioangioma

Karmegaraj, Balaganesh; Ibrahim, Syed; Razeen, Mohamed; Premasudha, Venkatanarayanan; Rajesh, Arasi

doi:10.1111/echo.15276

Cited by 3 publications

(7 citation statements)

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“…Umbilico‐portosystemic venous anomalies affect approximately 1–2 every 10,000 fetuses, can cause shunting into the systemic veins, which is found to be associated with other anomalies such as genetic anomalies (especially aneuploidies, cardiac malformations and hydrops) 23–26 . It can also be associated with cardiac and extracardiac abnormalities without portosystemic shunt 27,28 . Except in extrahepatic portosystemic shunts (Umbilical vein‐Iliac vein), the genetic evaluation was normal in our cohort.…”

Section: Discussionmentioning

confidence: 65%

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Clinical presentation, conventional/4D spatio‐temporal image correlation imaging findings, pregnancy and early postnatal outcomes in fetuses having anomalies of systemic venous return in the absence of significant intracardiac defects: A retrospective study from two centres in Southern India

et al. 2022

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Background Recent advances in fetal ultrasound imaging, especially four‐dimensional (4D) spatio‐temporal image correlation techniques permit detailed evaluation of the fetal venous system and its abnormalities. In this report, we present the clinical presentation, conventional/4D spatio‐temporal image correlation imaging findings, pregnancy, and early postnatal outcomes in fetuses having anomalies of systemic venous return in the absence of significant intracardiac defects from two centres in southern India. Objectives To report the clinical presentation, conventional/4D spatio‐temporal image correlation imaging findings, pregnancy, and early postnatal outcomes in fetuses having anomalies of systemic venous return in the absence of significant intracardiac defects from two centres in Southern India. Methods Retrospective study (October 2017 to March 2022). All fetuses referred with abnormal cardiac imaging findings who were diagnosed to have anomalies of systemic venous return in the absence of significant intracardiac defects were included. Imaging techniques like 2D with color and 4D spatio‐temporal image correlation fetal imaging were used to evaluate systemic venous anomalies. Systemic venous anomalies were grouped into cardinal venous anomalies and umbilico‐portosystemic venous anomalies. Results Thirty‐nine fetuses were included; this represented 4.4% of all cardiac anomalies diagnosed during the study period. Cardinal venous anomalies were seen in 29 fetuses (74%); the mean gestation age at diagnosis was 25.5 ± 3.4 weeks. Absent dilated coronary sinus was associated with anomalous drainage of superior caval vein through completely unroofed coronary sinus into the left atrium (n = 3) which resulted in cyanosis after birth in all infants. Among the three cases, one underwent surgery at 6 months of age due to a progressive increase in cyanosis (Spo2 78%) and others are awaiting surgery. A prenatal genetic evaluation was performed in 17 (58.6%). Cardinal venous anomalies were not associated with genetic abnormalities. Live births occurred in all fetuses with cardinal venous anomalies. Umbilico‐portosystemic venous anomalies were seen in 10 (26%). The mean gestation age at diagnosis was 26.5 ± 4.5 weeks. Except in a fetus with the extrahepatic portosystemic shunt (umbilical vein to iliac vein), the genetic evaluation was normal in our cohort. Extracardiac anomalies (n = 3/10; 30%) were seen in both intra (n = 1) and extrahepatic portosystemic shunts (n = 2). Conclusion Anomalies of systemic venous return in the absence of significant intracardiac, extracardiac, and genetic abnormalities carried an overall favorable prognosis in our cohort. Precise characterization of anatomic details using advanced imaging techniques helps in the understanding of this complex three‐dimensional anatomy and in the prognostication of these anomalies.

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Section: Discussionmentioning

confidence: 65%

“…[23][24][25][26] It can also be associated with cardiac and extracardiac abnormalities without portosystemic shunt. 27,28 Except in extrahepatic portosystemic shunts (Umbilical vein-Iliac vein), the genetic evaluation was normal in our cohort. Extracardiac anomalies were seen in both intra (n = 1) and extrahepatic portosystemic shunts…”

Section: Discussionmentioning

confidence: 66%

Clinical presentation, conventional/4D spatio‐temporal image correlation imaging findings, pregnancy and early postnatal outcomes in fetuses having anomalies of systemic venous return in the absence of significant intracardiac defects: A retrospective study from two centres in Southern India

et al. 2022

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“…Situs inversus of the thoracic organs with situs solitus of the abdominal organs is rare in children and has been termed thoracic‐abdominal discordance which is usually associated with normal hearts 5 . 3D HD‐live tissue rendering has a superior value in understanding complex cardiac morphology 6 . The virtual plane images given by 3D/4D STIC imaging are not generally accessible with 2D approach which helps examiner to understand, appreciate, and confidently diagnose abdominal and thoracic situs abnormalities antenatally 7 …”

Section: Figurementioning

confidence: 99%

Three‐dimensional high‐definition live tissue virtual dissection of mirror‐image dextrocardia with thoracic‐abdominal discordance in a fetus

Karmegaraj

2024

Echocardiography

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“…Fetal ventricular disproportion is a common finding and referral for fetal echocardiography 1 . Disproportion in four‐chamber view (4CH) in fetal heart can have many causes and be a physiologic finding, or a symptom of functional abnormalities or congenital heart disease (CHD) 2–10 . Disproportion is very easy to see during an ultrasound scan, but if isolated, it is sometimes difficult to differentiate its cause.…”

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confidence: 99%

“…Sometimes, disproportion is normalized during pregnancy and then there is no need to further examination 8,21 …”

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confidence: 99%

Differential diagnosis in disproportion in four‐chamber view in fetus in late pregnancy—Challenging dilemma

Słodki

2024

Echocardiography

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Fetal ventricular disproportion is a common finding and referral for fetal echocardiography. 1 Disproportion in four-chamber view (4CH) in fetal heart can have many causes and be a physiologic finding, or a symptom of functional abnormalities or congenital heart disease (CHD). [2][3][4][5][6][7][8][9][10] Disproportion is very easy to see during an ultrasound scan, but if isolated, it is sometimes difficult to differentiate its cause. Physio-

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Prenatal diagnosis, management, and postnatal outcome of a fetus with massive cardiomegaly secondary to placenta chorioangioma

Cited by 3 publications

References 5 publications

Clinical presentation, conventional/4D spatio‐temporal image correlation imaging findings, pregnancy and early postnatal outcomes in fetuses having anomalies of systemic venous return in the absence of significant intracardiac defects: A retrospective study from two centres in Southern India

Clinical presentation, conventional/4D spatio‐temporal image correlation imaging findings, pregnancy and early postnatal outcomes in fetuses having anomalies of systemic venous return in the absence of significant intracardiac defects: A retrospective study from two centres in Southern India

Three‐dimensional high‐definition live tissue virtual dissection of mirror‐image dextrocardia with thoracic‐abdominal discordance in a fetus

Differential diagnosis in disproportion in four‐chamber view in fetus in late pregnancy—Challenging dilemma

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