Right Ventricular Dilatation in the Fetus: A Study of Associated Features and Outcome

Abstract

Right ventricular dilatation is an infrequent finding at fetal echocardiography. Previous studies have documented an association with aortic coarctation. However, there are associations with other congenital abnormalities. We reviewed our experience of fetal right heart dilatation in order to recognize concurrent anomalies and to assess the outcome of the affected fetuses. We studied all fetuses with right ventricular dilatation over a 5-year period. We documented associated cardiac and noncardiac lesions, and outcome data were assessed in terms of the number of fetuses that were born live and the number surviving to 2 months of age. Forty-three fetuses with right heart dilatation were seen. Fifteen had associated cardiac abnormalities: most commonly coarctation (n = 4) and VSD (n = 4). Seven had associated noncardiac abnormalities. There were seven fetuses who also had chromosomal abnormalities. In total, there were three terminations of pregnancy, four intrauterine deaths, one stillbirth and 35 live-births. Twenty-eight were alive at 2 months of age (70% of the nonterminated pregnancies). Fetal right heart dilatation is frequently associated with both cardiac and noncardiac congenital abnormalities. Our outcome figures suggest a guarded prognosis be given during counseling of parents of fetuses with right heart dilatation.

Postnatal outcome of fetal isolated ventricular size disproportion in the absence of aortic coarctation

“…We encountered a relatively high incidence (46%) of prenatally undetected congenital malformations amongst cases without CoA, which mainly comprised cardiac defects. The association of left–right ventricular disproportion with both cardiac and extracardiac pathology has been reported before by Hornung et al . and Axt‐Fliedner et al ,.…”

Effect of vitamin A deficiency on respiratory infection: Causal inference for a discretely observed continuous time non‐stationary Markov process

“…Pitfalls in the correct diagnosis of fetal CoA in previous studies included fetuses having additional sonographic findings, such as VSD and persistent LSVC that may be a cause of ventricular disproportion particularly in the early fetus because dilatation of the coronary sinus impairs left ventricular filling13, 14. In this study, persistent LSVC was seen as commonly in those with as in those without CoA, as we have reported previously4.…”

Diagnostic Ultrasound Features and Outcome of Restrictive Foramen Ovale in Fetuses With Structurally Normal Hearts

“…The pathophysiological mechanisms of right heart dilatation may involve increased preload or afterload, but diagnosing the specific clinical aetiology of such changes requires the elimination of a long list of fetal and maternal conditions (Supplemental Table 1). Hornung et al [12] reported on 43 fetuses with right heart dilatation but made no reference to the presence of atrial septal aneurysm or restrictive FO. Among their fetuses, 19 (44 %) had isolated right heart dilatation, and 9 (21 %) showed significant noncardiac anomalies.…”