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[Isolated right aortic arch: prenatal diagnosis characteristics, pregnancy outcomes and systematic review].

Authors
  • Bitumba, I1
  • Lévy, M2
  • Bernard, J-P3
  • Ville, Y3
  • Salomon, L-J3
  • 1 Service de gynécologie obstétrique, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France. Electronic address: [email protected] , (France)
  • 2 Service de cardiologie pédiatrique, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France. , (France)
  • 3 Service de gynécologie obstétrique, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France. , (France)
Type
Published Article
Journal
Gynecologie, obstetrique, fertilite & senologie
Publication Date
Oct 01, 2019
Volume
47
Issue
10
Pages
726–731
Identifiers
DOI: 10.1016/j.gofs.2019.09.002
PMID: 31494313
Source
Medline
Keywords
Language
French
License
Unknown

Abstract

To investigate prenatal diagnosis characteristics and pregnancy outcomes associated with isolated right aortic arch (RAA). A retrospective study including fetuses with isolated RAA, managed between January 2010 and February 2018. Cases were identified from the ultrasound databases of the expert pediatric cardiologists, who made the aforementioned diagnosis. All fetuses were examined by a fetal medicine imaging expert to exclude any extracardiac abnormality. A systematic review was performed to assess the prenatal diagnosis and outcomes of fetuses with isolated RAA. Fifty-six fetuses were diagnosed with an isolated RAA. An isolated double aortic arch (DAA) was diagnosed in one fetus. Mean gestational age at diagnosis was 24 weeks. The sex ratio (boy/girl) was 0.89. No significant abnormality was detected in invasive tests (karyotype and FISH or microarray). Only one fetus was misdiagnosed with isolated RAA. He was the only symptomatic (stridor) newborn baby and was later diagnosed with DAA. Four studies were included in our systematic review representing 115 cases of isolated RAA. One significant chromosomal abnormality was detected: a 22q11 deletion in a newborn baby who had a postnatal finding of a soft palate cleft. There was one major obstetric complication: an intrauterine fetal demise at 41 gestational weeks. Diagnosis of isolated RAA can be challenging. Invasive tests are to be discussed. The diagnosis of isolated RAA should not change obstetric monitoring. Nevertheless, an echocardiography should be performed systematically in these new newborn babies within their first month of life. Copyright © 2019 Elsevier Masson SAS. All rights reserved.

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