Oral communication abstractsAttention to FV movement in late-term fetuses with disproportion can avoid false positive diagnosis of coarctation of the aorta.
OC255Fetal cardiosplenic syndromes (isomerism) -how alerting is the heart and stomach position on ultrasonography?K. Gagel*, K. S. Heling †, K. D. Kalache †, R. Bollmann † and R. Chaoui † *Klinik für Frauenheilkunde und Geburtshilfe, Germany and †Humboldt University, Charité-CCM, Berlin, Germany Background: Cardiosplenic syndromes are complex anomalies of the looping of visceral and cardiac situs known as left and right isomerism (polysplenia resp. asplenia). They are detectable prenatally due to known signs e.g. situs anomalies, cardiac defects, AV-Block. Less known signs include an abnormal position or absence of the inferior vena cava. Objective: Was to find out the proportion of cases potentially detectable by abnormal stomach and heart position resp. abnormal four-chamber-view (4 CV). Material and methods: Ultrasound findings of 33 cases were reviewed, including 19 with left and 14 with right isomerism. Cases with situs inversus with or without heart defects were excluded. Following parameters were analysed: stomach and heart apex position, abnormal four chamber view, presence of bradycardia.
Results:The stomach was on left-side in 48% (16/33) of the cases. Half of these had the heart on the left (levocardia) and the other half had dextrocardia. The stomach was on the right side in 52% (17/33) of the cases. In this group only 2 had dextrocardia and the remaining 15 cases had levocardia. 75% (25/33) of the whole population had an abnormal 4 CV or bradycardia. Conclusions: Common signs for isomerism are not very reliable in prenatal diagnosis, since gross abnormal four-chamber view resp. discordant positions of heart and stomach were found in 75% resp. 70% of all cases. Segmental analysis of the heart including the upper abdomen should therefore become part of teaching fetal echocardiography.