Document Detail


Fetal echocardiographic evaluation of atrial morphology and the prediction of laterality in cases of heterotaxy syndromes.
MedLine Citation:
PMID:  16184509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate whether abnormal atrial morphology, which is well recognized in autopsy series, is detectable by fetal echocardiographic examination of the four-chamber view, and can therefore be utilized to differentiate left from right isomerism in heterotaxy syndromes. METHODS: This study was a retrospective review of 30 cases with prenatally diagnosed heterotaxy syndromes. Ultrasound video recordings and still images were reviewed with respect to atrial morphology in the four-chamber view. In 25 cases the morphology of both atria was sufficiently well visualized on the recordings to be evaluated and only these were included in the study. RESULTS: Two types of atrial morphology were distinguished in our cohort: a sickle-shape with the tip pointing laterally and apically, and a blunt shape resembling the usual atrial appearance in the four-chamber view. Nineteen out of the 25 cases (76%) presented with isomerism of the atria in the four-chamber view. Thirteen had bilateral sickle-shaped atrial morphology, all associated with left isomerism. Six had bilateral blunt-shaped atrial morphology, all associated with right isomerism. The atria of the remaining six cases were not isomeric, the right atrium being sickle-shaped and the left blunt-shaped. Five of the latter cases were associated with left and one with right isomerism. CONCLUSIONS: The majority of prenatally diagnosed heterotaxy syndromes seem to present with isomeric atrial morphology in the four-chamber view. In these cases a differentiation between left and right isomerism can be based on the two distinct types of atrial morphology. This may further enhance the prenatal differentiation of these syndromes.
Authors:
C Berg; A Geipel; T Kohl; J Smrcek; U Germer; A A Baschat; M Hansmann; U Gembruch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  26     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-29     Completed Date:  2006-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  538-45     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2005 ISUOG.
Affiliation:
Department of Obstetrics and Prenatal Medicine, University of Bonn, and Division of Prenatal Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany. Christoph.Berg@ukb.uni-bonn.de
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Echocardiography / methods*
Female
Heart Atria / embryology,  ultrasonography
Heart Defects, Congenital / embryology,  ultrasonography*
Humans
Infant, Newborn
Predictive Value of Tests
Pregnancy
Retrospective Studies
Syndrome
Ultrasonography, Prenatal / methods*

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