Aberrant right subclavian artery: incidence and correlation with other markers of Down syndrome in second‐trimester fetuses

Paladini, D.; Sglavo, G.; Pastore, G.; Masucci, A.; D’Armiento, Maria; Nappi, Carmine

doi:10.1002/uog.10053

Cited by 51 publications

(92 citation statements)

References 20 publications

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“…Several authors recommended karyotyping even if ARSA is the only positive marker [5,11], while it has been claimed that ARSA without another sonographic finding is not a powerful enough argument to recommend karyotyping [12]. In three previous series there was no case of trisomy 21 with isolated ARSA [4,6,12].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, in the series with 8 fetuses with ARSA and Down syndrome, Borenstein et al [5] reported that only 1 fetus (12.5%) had ARSA as an isolated finding. Recently, Paladini et al [11] reported a series of 27 fetuses with ARSA and Down syndrome, and ARSA was isolated finding in 8 (29.6%) of them. In the same study, the authors drew the conclusion that ARSA should be considered among the three most powerful ultrasound indicators of Down syndrome in second trimester, together with nasal bone hypoplasia/absence and increased nuchal fold [11].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Paladini et al [11] reported a series of 27 fetuses with ARSA and Down syndrome, and ARSA was isolated finding in 8 (29.6%) of them. In the same study, the authors drew the conclusion that ARSA should be considered among the three most powerful ultrasound indicators of Down syndrome in second trimester, together with nasal bone hypoplasia/absence and increased nuchal fold [11]. In our series, in 60% (6/10) of cases with trisomy 21 and ARSA, there were no additional findings.…”

Section: Discussionmentioning

confidence: 99%

“…However, whether ARSA can be used as an isolated marker of Down syndrome, or only in combination with cardiac or extracardiac sonographic findings is yet to be established. Some of the previous studies showed the presence of trisomy 21 in cases with isolated ARSA [2,9,10,11], while in the other studies ARSA was associated with another sonographic finding in all cases with a chromosomal anomaly [4,6,12]. Moreover, the estimated likelihood ratio of isolated ARSA for Down syndrome was reported as 3.94 in a meta-analysis [8].…”

Section: Introductionmentioning

confidence: 99%

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Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery

Esmer

Gül²,

Nehir

et al. 2013

Fetal Diagn Ther

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Objective: The purpose of this study was to determine the frequency of chromosomal anomalies among the fetuses with isolated and non-isolated aberrant right subclavian artery (ARSA), and to evaluate the sonographic findings associated with ARSA. Methods: This is a retrospective study conducted during the period between January 2008 and December 2012 at the maternal fetal medicine units of three different referral centers. Results: Among the 148 cases of ARSA, 98 were isolated and 50 were associated with cardiac anomalies, extracardiac malformations or soft markers. Trisomy 21 was the only chromosomal anomaly with a prevalence of 6.8% (10/148). The corresponding rate was 6.1% (6/98) and 8% (4/50) for isolated and non-isolated ARSA, respectively. Cardiac anomalies, extracardiac findings and soft markers were detected in 5.4% (8), 10.8% (16) and 24.3% (36) of cases, respectively. Among the 10 fetuses with trisomy 21, 6 were isolated, 4 were associated with soft markers, 2 were associated with fetal growth restriction and 1 was associated with hydrops fetalis. Cardiac anomalies were not observed in any of these fetuses. Conclusion: The prenatal diagnosis of ARSA should prompt meticulous anatomic survey, and karyotype analysis might be offered even in the absence of associated findings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery

Esmer

Gül²,

Nehir

et al. 2013

Fetal Diagn Ther

View full text Add to dashboard Cite

show abstract

“…In the postnatal period, and most recently also in the prenatal period, ARSA was found significantly more often in subjects with congenital heart disease (CHD) [8] or chromosomal abnormalities, particularly trisomy 21 [9,10,11], with the relative risk multiplied by 3.94 [12]. …”

Section: Introductionmentioning

confidence: 99%

Prenatal Associated Features in Fetuses Diagnosed with an Aberrant Right Subclavian Artery

Pico¹,

Mancini

Lafouge³

et al. 2016

Fetal Diagn Ther

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Objective: The objective of this study was to determine the frequency and the nature of associated anomalies, especially malformations and chromosome abnormalities, in a population of fetuses with an aberrant right subclavian artery (ARSA). Materials and Methods: This is a 7-year descriptive study. All patients whose fetus had an ARSA diagnosed by ultrasound performed during the 1st, 2nd, or 3rd trimester of pregnancy were included, regardless of their risk of chromosomal abnormalities. Results: Between May 2007 and April 2014, an ARSA was diagnosed in 120 fetuses. The outcome was found in 108 cases (90%). ARSA was an isolated finding in 54/108 cases (50%). In 20% (22/108) of the fetuses, chromosomal abnormalities were detected. No chromosomal abnormalities were found in fetuses with an isolated ARSA. 82% (18/22) of chromosomal abnormalities were usual, such as trisomies 21 and 18, monosomy X, and 22q11.2 deletion. 21% (23/108) of the fetuses presenting an ARSA were associated with having a congenital heart disease. Conclusion: The presence of an isolated ARSA is a condition rarely associated with a chromosomal abnormality. The decision to perform an invasive karyotyping procedure under such circumstances or not may be made according to the principle of parental autonomy after extensive counselling and mostly a thorough assessment of the fetus.

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The Fetal 3‐Vessel Views: An Illustrative Case‐Based Tutorial

Anton

Sklansky

Perez

et al. 2019

J of Ultrasound Medicine

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In 2018, the American Institute of Ultrasound in Medicine revised its obstetric Practice Parameter for the second-trimester fetal anatomic survey. The 2018 Practice Parameter recommends incorporation of the 3-vessel view and 3-vessel and trachea view "if technically feasible." Sonographers and other medical providers may require additional training and education to develop greater proficiency in obtaining and interpreting these views. This pictorial essay, including ultrasound images alongside their respective schematic diagrams, provides an upto-date, practical, and clinically oriented review of the 3-vessel view and 3-vessel and trachea view and their most common presentations in the context of congenital heart disease.

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Aberrant right subclavian artery: incidence and correlation with other markers of Down syndrome in second‐trimester fetuses

Abstract: Objective To assess the incidence of aberrant right subclavian artery (ARSA)

Cited by 51 publications

References 20 publications

Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery

Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery

Prenatal Associated Features in Fetuses Diagnosed with an Aberrant Right Subclavian Artery

The Fetal 3‐Vessel Views: An Illustrative Case‐Based Tutorial

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