Dextrocardia detected in 23rd wk. prenatal ultrasound

[ShelbyT24]

Last week, during a routine prenatal ultrasound, a possible dextocardia(heart on right, stomach on left) was observed. I was told to return for another ultrasound at the 32nd week.
   My husband and I serve with a mission in Mali, a developing, French-speaking country in W. Africa.  The national doctor performing the ultrasound wrote: (translated as best I can into English) Heart:4 symmetrical cavities(chambers?), septum intact, depart(outflow?)of large vessels normal, auricular?-ventricle valves viewed, aorta at 6.2mm and pulmonary artery at 7.5 mm. Diaphragm present. Fetal morphology: Normal for term, aside from presence of dextrocardia. Our family has no known history of Congenital Heart Defects or anomalies.
   If our baby girl does indeed have dextrocardia (w/out lat. reversal of other organs in chest and abdomen), it seems there is a high probability she may be born with Kartegners Syndrome or another syndrome that may require intensive neonatal care.
  Knowing neonatal intensive care and pediatric cardiology do not yet exist here, we are returning to the States for her birth. We plan to return five weeks before the due date, 2/22/05, but would return sooner if there were any possible advantages.  
  If we were already back in the U.S, is there anything more we could do now or later?  What specific diagnostic tests should we know about?  Assuming a worst-case scenario, what procedures or surgeries are available for a newborn with complications from dextrocardia?
Thank you so much for your consideration.
Best Regards,
Shelby

[Cleveland Clinic]

Shelby,

This question is well out of my area of expertise with respect to the neonatal care and diagnostic testing and more appropriately discussed with a pediatric cardiologist and a maternal fetal medicine OB-Gyn.

There are both primary causes and secondary causes of dextrocardia which may be associated with multiple other congenital abnormalities besides Kartegners.  There is also an outside chance that the ultrasound is not correct.

Alot of diagnostic and therapeutic options become more limited as pregancy progresses.  Since you are planning on returning ot the US to deliver, I would contact the OB-Gyn whom you will have involved in the care to discuss what specific options there are and timing limitations that might be involved in the pregancy.

good luck

[mmfd]

I am so sorry to hear about your baby.  I guess one good thing is that it was picked up before delivery.  And maybe the echo was wrong; they are not always right.  Good luck.

[ShelbyT24]

My husband (J) & I decided eight weeks was too long to wait for a second ultrasound evaluation as recommended by the doctor I saw last Wednesday.  So we made an appointment to see a different doctor (OB-Gyn and med. school professor) for a second opinion to see if he would also detect a dextocardia.  He had a time slot open for last night, Tuesday pm.  J wasn't able to return from his flight in time to come with me for this visit, but our friend Julie who is a nurse, was able to come along for moral support and to help me interpret (from French) whatever the doctor would have to say.

Great news!  You were right, the echo, in this case WAS wrong! The sonogram images from Tues. pm clearly showed that our baby does NOT have dextrocardia.  While the OB-Gyn took my concern seriously, he reassured me that based on all his findings, there is no need to worry about a congenital heart defect or any other anomalies.  He said that, as we all know, even very good technicians (in this case, reputedly the best one in Bamako - capital city) can make mistakes due to the "geometry" our minds have to process in interpreting the images from various angles.  After writing his own report of the ultrasound last night, he reviewed the first doctor's report.  Other than the part about the dextrocardia, there were no contraditions between the two reports.  Everything indicates our baby is developing normally and is in good health!  My friend and I have complete confidence in what this second doctor showed us and what he said.  

The past week was a very long one for our family.  For me, the hours sometimes felt like days as we waited, not knowing what the future might hold.  Through it all, God has guarded our hearts and minds with His peace that surpasses our human understanding.  J and I had a girl's name picked out months ago, before we knew if we'd be having another girl.  Last Wednesday when we got the news that our baby might have dextrocardia, we also found out that we're expecting a girl (second daughter, third child).  We've named her Sophia Anne, meaning Wisdom and Grace.  Every time we've said her name since then, I can't help but be reminded that God in his wisdom has allowed us to go through this dark time, and through it, has provided His grace to sustain us. I don't know why we had to go through this, but it HAS strengthened my faith and this experience will also help us to better empathize with others going through their own times of waiting and uncertainty.  Hope this helps someone out there.

Final thought, when in doubt, get a second opinion.

[soma829]

A related discussion, chances of congenital heart disease was started.